growth hormone

Overview

Growth hormone (GH), also called somatotropin, is a peptide hormone produced by the anterior pituitary gland and is a central regulator of postnatal growth, body composition, and metabolism. Its actions are mediated both directly and indirectly, in part through stimulation of insulin-like growth factor-1 (IGF1), which contributes to linear growth and tissue anabolism. GH secretion is pulsatile and is regulated by hypothalamic signals, nutritional status, sleep, and feedback from downstream hormones.

Clinically, GH is important in disorders of growth failure and in acromegaly, where excess GH production leads to elevated IGF1 and characteristic systemic complications. Recombinant GH and long-acting GH formulations are used therapeutically in selected pediatric and adult conditions, while biochemical assessment of GH and IGF1 remains essential for diagnosis, treatment monitoring, and evaluation of discordant hormone patterns.

Focus of Latest Publications

Recent publications on growth hormone have focused largely on acromegaly management, growth hormone replacement strategies, and the downstream metabolic effects of altered GH signaling. In surgically treated acromegaly, investigators examined postoperative discordance between growth hormone and IGF1, highlighting that one marker may be within the reference range while the other remains abnormal, complicating assessment of disease activity. Related work also compared GH/PRL-positive pituitary adenomas with GH-only adenomas over a 15-year single-center experience to evaluate whether prolactin co-expression is associated with distinct pathological features or treatment outcomes.

Several studies evaluated therapies that either replace or modulate growth hormone action. In children with Noonan syndrome, a randomized phase 3 trial assessed once-weekly somapacitan, a long-acting reversible albumin-binding GH, against daily GH to address the burden of frequent injections. In adults with growth hormone deficiency, the foresiGHt trial examined once-weekly lonapegsomatropin as a sustained-release prodrug designed to reduce the burden of daily somatropin therapy. Another study in children born small for gestational age receiving GH reported that they had similarly impaired glucose-insulin metabolism as children with obesity, underscoring the metabolic monitoring needs associated with GH treatment.

Other publications explored the broader physiological consequences of GH-related interventions. In juvenile rainbow trout, vaccination was associated with reduced length growth without changes in feed intake or aerobic metabolism, and this effect appeared to be mediated through reduced IGF1 production rather than altered oxygen uptake. In acromegaly, a case report described a patient with a GH- and prolactin-secreting pituitary macroadenoma and residual invasive disease whose severe headache and elevated IGF1 persisted despite surgery, radiotherapy, octreotide, cabergoline, and pegvisomant; initiation of pasireotide long-acting release led to rapid normalization of IGF1 and complete headache resolution. Together, these studies emphasize the clinical complexity of interpreting GH/IGF1 biology and the ongoing development of longer-acting GH therapies and targeted treatments for GH excess.