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Most people experience symptoms on one side only

Biochem Biophys Res Commun 467:491496

(2) changes in the serum levels of ALT and aspartate transaminase (AST)

As a consequence, CD38 may be a potential therapeutic target for HF and Alzheimers disease

Malnutrition or malabsorption causes decreased insulin signaling which reduces GHR expression and blocks the GH signaling pathway leading to IGF-I expression (GHR uncoupling), while GHs metabolic actions on lipolysis and gluconeogenesis are unaffected