The biology of NAFLD - Hepatic lipid accumulation https://pubmed.ncbi.nlm.nih.gov/28428362/
This seems like a good review of liver fat accumulation but quite complex and detailed. I think there is a simple message that comes from it though that's worth understanding.
In the Abstract they list the 4 major mechanisms by which fat accumulates in the liver.
Hepatic lipid accumulation may be induced by 4 separate mechanisms:
(1) increased hepatic uptake of circulating fatty acids,
(2) increased hepatic de novofatty acid synthesis,
(3) decreased hepatic beta-oxidation and
(4) decreased hepatic lipid export.
In Fig 1 on page 5 they show those 4 mechanisms in diagrammatic form. 1) and 2) are ways for fat to build-up in the liver and 3) and 4) are ways to remove it. If you open the valves for 1 and 2 fat builds up in the liver, if you close them it slows the build-up. If you open the valves for 3 and 4 then fat is washed away from the liver, close 3 and 4 and it builds up. It's a quite neat model I think. Growth hormone (GH) is implicated in 3 of those 4 mechanisms. It blocks both the transport of fat from adipose tissues to the liver and it inhibits the livers own ability to produce new fat. It also speeds up the conversion of fatty molecules in the liver to VLDL for their export.
I don't think I've had it explained to me this simply before. I listened to Steven Harrison explain another drugs role in liver fat clearance wrt these 4 basic mechanisms and found that quite compelling, it's good to see you can do the same thing with growth hormone.
The text is pretty detailed but it does explain each mechanism in each section but doesn't refer to GH's role too much.
Anybody trying to understand the POTENTIAL of any GH approach to NAFLD would do well to understand this "4 mechanisms of fat accumulation" approach.