Physiology of growth hormone
- Shlomo Melmed, MD
Shlomo Melmed, MD
- Senior Vice President and Dean
- Cedars Sinai Medical Center
- Professor of Medicine
- University of California at Los Angeles School of Medicine
Growth hormone (GH) is produced by the pituitary somatotroph cells. GH production begins early in fetal life and continues throughout life, although at a progressively lower rate.
The basic aspects of GH physiology will be reviewed here. This discussion will include the GH gene, the mechanisms and regulators of GH secretion, and a summary of the actions of GH. The physiology of insulin-like growth factor-1 (IGF-1), which mediates most peripheral actions of GH, is discussed separately. (See "Physiology of insulin-like growth factor 1".)
Clinical issues related to GH excess (acromegaly) or GH deficiency in children and adults are also presented separately. (See "Treatment of growth hormone deficiency in children" and "Pituitary gigantism" and "Growth hormone deficiency in adults" and "Causes and clinical manifestations of acromegaly".)
The human growth hormone (GH) gene family comprises five distinct genes, all located on chromosome 17q22 . The pituitary GH gene (GH-N) encodes two alternatively spliced mRNA products, which give rise to the abundant circulating 22 kDa GH molecule and a less abundant (10 percent of circulating GH) 20 kDa GH lacking amino acids 32 to 46. Placental syncytiotrophoblast cells express a GH variant (hGH-V), as well as three other genes for human chorionic somatotropin (hCS). During pregnancy, maternal GH secretion declines and is replaced by rising placental-derived GH. (See "Maternal adaptations to pregnancy: Endocrine and metabolic changes", section on 'Anterior pituitary'.)
Regulation of the pituitary GH-N gene appears to be under complex hormonal, developmental, and tissue-specific control mediated by regulatory elements of the gene . The tissue-specific development of somatotrophs and expression of GH appear to be largely determined by the POU1F1 (Pit-1) transcription factor . (See "Principles of molecular genetics".)
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