Book recommended: Medical Physiology by Jaypee

1. Growth Hormone
DANISH HASSAN
LECTURER, UNIVERSITY OF SARGODHA

2. Hormone
 A hormone is usually studied as follows:
1. Synthesis & Source of secretion
2. Chemistry
3. Half life
4. Metabolism
5. Actions
6. Mode of action
7. Regulation of secretion
8. Applied physiology

3. Growth Hormone
 Synthesis & Source of Secretion
 Synthesized by chromphill cells of anterior pituitary.
 Secreted by somatotropes which are the
acidophilic cells of anterior pituitary.
 They are in fact regulated by neuro-hormones
secreted by hypothalamus

4.  Chemistry, Blood Level and Daily Output
 Protein in nature, having a single-chain polypeptide
with 191 amino acids.
 Its molecular weight is 21,500.
 Basal level of GH concentration in blood:
 Normal adult: 300 g/dL
 Children:500 ng/dL
 Its daily output in adults is 0.5 to1.0 mg.

5.  Normal Growth Hormones Levels in
Body(Random)
1. Men: < 5 ng/mL or < 226 pmol/L
2. Women: < 10 ng/mL or < 452 pmol/L
3. Children: 0-20 ng/mL or 0-904 pmol/L
4. Newborns: 5-40 ng/mL or 226-1808 pmol/L

6.  Half-life and Metabolism
 Half-life of circulating growth hormone is about 20
minutes.
 It is degraded in liver and kidney
 Transport
 Transported in blood by GH-binding proteins
(GHBPs)

7.  Mode of Action of GH:
 GH act through somatomedin is a poly-peptide
through which growth hormone acts.
 It is secreted by liver.
 Somatomedins are of two types:
1. Insulin-like growth factor-I (IGF-I), which is also called
somatomedin C, acts on bones and protein
metabolism.
2. Insulin-like growth factor-II, plays an important role in
growth of fetus

8.  GH is transported in blood by loose binding with
plasma protein.
 It is released from plasma protein rapidly.
 Action also lasts only for a short duration of 20 minutes.
 But, the somatomedin C binds with plasma proteins
very strongly.
 Because of this, the molecules of somatomedin C are
released slowly from the plasma proteins.
 The action of somatomedin C lasts for about 20 hours.

9.  Mode of action of somatomedin C:
 Somatomedin C acts through the second messenger
called cyclic AMP
 GH receptor is called growth hormone secretagogue
 GH binds with the receptor situated mainly in liver cells
and forms the hormonereceptor complex.
 Hormone-receptor complex induces various
intracellular enzyme pathways, resulting in
somatomedin secretion.
 Somatomedin in turn, executes the actions of growth
hormone.

12.  Actions of Growth Hormone
 Responsible for the general growth of the body
 It increases the size and number of cells by mitotic
division.
 Also causes specific differentiation of certain types
of cells like bone cells and muscle cells.
 GH affects
1. Metabolism of carbohydrates, fats & proteins
2. Bones

13.  Metabolism of Proteins:
 GH accelerates the synthesis of proteins by:
1. Increasing amino acid transport through cell
membrane
2. Increasing transcription of DNA to RNA
3. Increasing ribonucleic acid RNA translation
4. Decreasing catabolism of protein
5. Promoting anabolism of proteins indirectly

14.  Metabolism of Fats:
 GH mobilizes fats from adipose tissue.
 Increases the concentration of fatty acids which
are used for the production of energy by the cells.
 Proteins are spared.
 During the utilization of fatty acids for energy
production, lot of aceto-acetic acid is produced by
liver and is released into the body fluids, leading to
ketosis.

15.  Sometimes, excess mobilization of fat from the
adipose tissue causes accumulation of fat in liver,
resulting in fatty liver

16.  Metabolism of Carbohydrates:
 Effects of GH on carbohydrate metabolism:
1. Decrease in the peripheral utilization of glucose for
the production of energy
2. Increase in the deposition of glycogen in the cells
3. Decrease in the uptake of glucose by the cells
4. Diabeto-genic effect of GH

17.  Effects on Bone:
 In embryonic stage, GH is responsible for the
differentiation and development of bone cells.
 In later stages, GH increases the growth of the
skeleton.
 It increases both the length as well as the thickness
of the bones.

18.  In bones, GH increases:
1. Synthesis and deposition of proteins by chondrocytes
and osteogenic cells
2. Multiplication of chondrocytes and osteogenic cells
by enhancing the intestinal calcium absorption
3. Formation of new bones by converting chondrocytes
into osteogenic cells
4. Availability of calcium mineralization of bone matrix.

19.  GH increases the length of the bones, until epiphysis
fuses with shaft, which occurs at the time of
puberty.
 After the epiphyseal fusion, it stimulates the
osteoblasts strongly.
 Bone continues to grow in thickness throughout the
life particularly, the membranous bones such as the
jaw bone and the skull bones become thicker
under the influence of GH.

23. Regulation of GH Secretion
GH secretion is stimulated by:
1. Hypoglycemia
2. Fasting
3. Starvation
4. Exercise
5. Stress and trauma
6. Initial stages of sleep.
GH secretion is inhibited by:
1. Hyperglycemia
2. Increase in free fatty
acids in blood
3. Later stages of sleep

25.  Regulation of GH:
 GH secretion is under negative feedback control
 Hypothalamus releases GHRH and GHRP, which in
turn promote the release of GH from anterior
pituitary.
 GH acts on various tissues. It also activates the liver
cells to secrete somatomedin C (IGF-I)
 Somatomedin C increases the release of GHIH from
hypothalamus.

26.  GHIH, in turn inhibits the release of GH from pituitary.
 Somatomedin also inhibits release of GHRP from
hypothalamus.
 It acts on pituitary directly and inhibits the secretion
of GH