The development of synthetic recombinant human growth hormone (GH) in the 1980s has substantially advanced our understanding of the many effects of GH, not only on growth but also on metabolism and body composition, as well as on physical activity and cognition. Nevertheless, despite the widespread use of GH for the treatment of childhood growth disorders and adult GH deficiency, many functions of GH remain unknown. Together with its downstream effector insulin-like growth factor 1 (IGF-1), GH exerts powerful collective actions on fat, protein and glucose metabolism, and administration of recombinant human GH or activation of endogenous GH production has shown the potential to influence obesity. However, the clinical use of GH is not without controversy, and some doubts remain about possible long-term risks of GH therapy.
The Nature Reviews Endocrinology Focus issue on GH in health and disease includes five specially commissioned Reviews, written by key opinion leaders in research and clinical practice. This timely Focus issue provides an overview of the different uses of GH therapy, including the treatment of children with idiopathic short stature and adults with GH deficiency, as well as insights into the diagnosis and management of these disorders. Topics in this Focus issue also include the effects of altered GH and IGF-1 signalling on obesity and lifespan, and the therapeutic benefits and risks of medical disruption of the GH/IGF-1 axis. This collection of articles on GH will be an educational resource to clinicians and scientists in the endocrinology community, covering the breadth of basic, translational and clinical research.
Image credit: NPG.
RESEARCH HIGHLIGHTS
Growth hormone in health and disease: Consensus guidelines for GH therapy in Prader—Willi syndrome—this way forward?
Linda Koch
doi:10.1038/nrendo.2013.88
Nature Reviews Endocrinology 9, 313 (2013)
Growth hormone in health and disease: Novel ghrelin mimetic is safe and effective as a GH stimulation test
Linda Koch
doi:10.1038/nrendo.2013.89
Nature Reviews Endocrinology 9, 315 (2013)
NEWS & VIEWS
Growth hormone in health and disease: Long-term GH therapy—benefits and unanswered questions
David Clemmons
doi:10.1038/nrendo.2013.68
Nature Reviews Endocrinology 9, 317-318 (2013)
Growth hormone in health and disease: Prader–Willi syndrome—GH therapy and bone
Graziano Grugni
doi:10.1038/nrendo.2013.74
Nature Reviews Endocrinology 9, 320-321 (2013)
Growth hormone in health and disease: Biological markers of tissue-specific effects of GH therapy
Alan D. Rogol
doi:10.1038/nrendo.2013.80
Nature Reviews Endocrinology 9, 318-320 (2013)
REVIEWS
Treatment of children and adolescents with idiopathic short stature
Michael B. Ranke
doi:10.1038/nrendo.2013.71
Nature Reviews Endocrinology 9, 325-334 (2013)
Idiopathic short stature (ISS) is a term used for children with short stature that does not have a specific cause. This Review outlines the diagnostic evaluation and possible psychological consequences of ISS. Various strategies to treat children with ISS are discussed, together with an evaluation of the efficacy and safety of these approaches.
Diagnosis and treatment of growth hormone deficiency in adults
Atil Y. Kargi & George R. Merriam
doi:10.1038/nrendo.2013.77
Nature Reviews Endocrinology 9, 335-345 (2013)
Adult growth hormone (GH) deficiency is now recognized as a distinct if nonspecific syndrome with considerable adverse health consequences. This Review outlines the physiological regulation and nonstatural effects of GH, and summarizes the consequences of adult GH deficiency, and the benefits and possible risks of GH replacement therapy.
The GH/IGF-1 axis in obesity: pathophysiology and therapeutic considerations
Darlene E. Berryman, Camilla A. M. Glad, Edward O. List & Gudmundur Johannsson
doi:10.1038/nrendo.2013.64
Nature Reviews Endocrinology 9, 346-356 (2013)
Administration of recombinant human growth hormone (GH) or activation of endogenous GH production exhibits great potential to influence the onset and metabolic consequences of obesity; however, the clinical use of GH is not without controversy. This Review provides an introduction to the role of GH in obesity and summarizes clinical and preclinical data that describe how GH can influence the obese state.
Growth hormone and cognitive function
Fred Nyberg & Mathias Hallberg
doi:10.1038/nrendo.2013.78
Nature Reviews Endocrinology 9, 357-365 (2013)
In humans, growth hormone (GH) has major effects on brain function. Fred Nyberg and Mathias Hallberg outline the mechanisms that underlie the interactions between GH and the central nervous system. The role of GH as a treatment for patients with cognitive impairment owing to GH deficiency is also discussed.
The GH/IGF-1 axis in ageing and longevity
Riia K. Junnila, Edward O. List, Darlene E. Berryman, John W. Murrey & John J. Kopchick
doi:10.1038/nrendo.2013.67
Nature Reviews Endocrinology 9, 366-376 (2013)
This Review summarizes data on mouse strains with mutations that affect growth hormone (GH) and insulin-like growth factor 1 (IGF-1) action and their effects on lifespan. The outcome of corresponding or similar mutations in humans is described, as well as the potential mechanisms underlying increased longevity and the therapeutic benefits versus risks of medical disruption of the GH/IGF-1 axis in humans.
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