Last edited: 9/4/2021

6. GROWTH HORMONE
Endocrinology | Growth Hormone Medical Editor: Ilia-Presiyan Georgiev

o The DNA undergoes transcription and produces

OUTLINE mRNA
o The mRNA goes to the ribosomes and is translated
I) SYNTHESIS into protein
II) EFFECTS OF GROWTH HORMONE o The protein undergoes modifications in the rough ER
III) EFFECTS OF IGF TYPE 1
and the Golgi apparatus and eventually is released in
IV) REVIEW QUESTIONS
V) REFRENCES the circulation
This protein is called Insulin-like growth factor (IGF)
type 1

(B) GLUCONEOGENESIS
(1) In the liver
I) SYNTHESIS
GH also stimulates gluconeogenesis
(1) The arcuate nucleus o Increases the blood glucose levels by producing
in the hypothalamus secretes growth hormone glucose from non-carbohydrate sources
releasing hormone (GHRH)  Glycerol
o Secondary triggers  Odd chain fatty acids
 ↑ amino acid levels in the blood
 ↓ glucose levels in the blood
• Hypoglycemia
 ↓ fatty acid levels in the blood
 Exercise
 Healthy stressors
GHRH goes in the hypophyseal portal system
o The vascular connection between the hypothalamus Figure 2 Effects of growth hormone in the liver.
and the anterior pituitary (adenohypophysis) (C) LIPOLYSIS
GHRH stimulates specific cells - the somatotropes in the (1) GH binds to
adenohypophysis to secrete growth hormone (GH) into
the bloodstream receptors in adipose tissue
o Triggers an intracellular mechanism
 Activates the enzyme hormone sensitive lipase
(HSL)
HSL initiates lipolysis
o The breaking down triglycerides into glycerol and fatty
acids
 Glycerol and the odd chain fatty acids are used for
gluconeogenesis

Figure 3 Effect of growth hormone in adipose tissue.

Figure 1 Growth hormone synthesis.
(1) GH binds to
II) EFFECTS OF GROWTH HORMONE
(A) IGF TYPE 1 PRODUCTION
(1) Certain percentage of the secreted GH
goes and binds to specific receptors in the liver
o Tyrosine kinase-like receptor
o Has a specific part that activates the
phosphorylation of specific types of amino acids
(D) AMINO ACID UPTAKE
receptors present on the surface of skeletal muscle cells
o Activates specific signaling pathway
o Activates the nucleus
o The nucleus activates specific genes
 Produces specific types of proteins
These proteins activate specific channels for amino acids
on the cell membrane
o ↑ amino acid uptake

The enzyme Janus kinase (JAK) is activated

o Phosphorylates the signal transducer activator of
transcription (STAT)
(2) When activated STAT
goes to the nucleus
Binds to a specific gene sequence of DNA
Figure 4 Effect of growth hormone on the skeletal muscles.

Growth hormone ENDOCRINE PHYSIOLOGY: Note #6. 1 of 3

 III) EFFECTS OF IGF TYPE 1 o Overall, the bones get bigger and thicker –
appositional growth
(A) EFFECTS ON THE SKELETAL MUSCLES The activated osteoblast and osteoclasts increase the
(1) IGF1 binds to endochondral ossification

receptors present on the surface of skeletal muscle cells (2) IGF type 1 also stimulates
o Activates specific signaling pathway protein synthesis which increases the density of the
o Activates the nucleus bones
o The nucleus activates specific genes o ↑ production of collagen type 1
 Produces specific types of proteins
In the bones there is collagen type one
These proteins activate specific channels for amino acids
o ↑ increased production of proteoglycans
on the cell membrane
o ↑ amino acid uptake
(2) Inside the cell
another pathway stimulates the amino acids
o Amino acids link together and produce proteins
 Myofibrils
• Actin
• Myosin
This causes hypertrophy of the muscles
o ↑ the overall size of the muscles

Figure 6 Effects of IGF type 1 on the bones.

(C) EFFECTS ON THE CARTILAGE

(1) In the epiphyseal plates
IGF type 1 affects the chondroblasts
o ↑ differentiation into certain types of bone tissue
o ↑ size
o ↑ proliferation
As a result, the bones grow in length – interstitial
growth

Figure 5 Effects of IGF type 1 on the skeletal muscles.

(B) EFFECTS ON THE BONE

(1) IGF type 1 regulates
the osteoblasts and osteoclasts cells inside the bones
o Highly activates and regulates the activity of both Figure 7 Effects of IGF type 1 on the cartilage.
 ↑ bone deposition (osteoblasts)
 ↑ bone resorption (osteoclasts)

IV) APPENDIX

Adipose Skeletal
Liver Bones Cartilage
tissue muscles
Produces Insulin-
Growth like growth factor ↑ amino acid
Lipolysis
hormone type 1 uptake
Gluconeogenesis
↑ bone deposition
↑ amino acid ↑ differentiation
Insulin-like (osteoblasts)
uptake into certain types
↑ bone resorption
growth factor ↑ the overall of bone tissue
(osteoclasts)
type 1 size of the ↑ size
appositional growth
muscles ↑ proliferation
↑ endochondral ossification

2 of 3 ENDOCRINE PHYSIOLOGY: Note #6. Growth hormone

 V) REVIEW QUESTIONS VI) REFRENCES

Which nucleus secretes GHRH?

● Le T, Bhushan V, Sochat M, Chavda Y, Zureick A. First Aid for
a. Preoptic nucleus the USMLE Step 1 2018. New York, NY: McGraw-Hill Medical; 2017
b. Supraoptic nucleus ● Marieb EN, Hoehn K. Anatomy & Physiology. Hoboken, NJ:
c. Arcuate nucleus Pearson; 2020.
● Boron WF, Boulpaep EL. Medical Physiology.; 2017.
d. Paraventricular nucleus ● Jameson JL, Fauci AS, Kasper DL, Hauser SL, Longo DL,
Loscalzo J. Harrison's Principles of Internal Medicine, Twentieth
Which is not a secondary trigger for GHRH Edition (Vol.1 & Vol.2). McGraw-Hill Education / Medical; 2018
● Hall JE, Hall ME. Guyton and Hall Textbook of Medical
secretion? Physiology. Philadelphia, PA: Elsevier; 2021.
a. ↓ amino acid levels in the blood
b. ↓ glucose levels in the blood
c. ↓ fatty acid levels in the blood
d. Exercise

Which cells are stimulated by the GHRH?

a. Corticotropes
b. Somatotropes
c. Thyrotropes
d. Gonadotropes

Which tissue is not affected directly by the growth

hormone?
a. Liver
b. Skeletal muscles
c. Adipose tissue
d. Bones

Which enzyme initiates the production of IGF type

1?
a. JAK
b. STAT
c. HSL
d. pkA

Which process is stimulated directly by the growth

hormone?
a. Glycogenosis
b. Glycolysis
c. Glycogenolysis
d. Gluconeogenesis

What is the main effect of the growth hormone in the

skeletal muscles?
a. Increased amino acid uptake
b. Increased protein synthesis
c. Both
d. Neither

IGF type 1 stimulates the productions of which

protein?
a. Glycerol
b. STAT
c. Myosin
d. growth hormone

Which protein increases bone density

a. Actin
b. Collagen type 1
c. Myosin
d. Collagen type 2

What is the name of the process where bones

increase in length?
a. Appositional growth
b. Interstitial growth
c. Endochondral ossification
d. Bone deposition

CHECK YOUR ANSWERS

Growth hormone ENDOCRINE PHYSIOLOGY: Note #6. 3 of 3