Obesity |
↓ |
↔ ↓ |
Decreased GH secretion (possibly through low ghrelin concentrations). Normal IGF-I bioactivity. |
( 2626. Schilbach K, Gar C, Lechner A, Nicolay SS, Schwerdt L, Haenelt M, et al. Determinants Of The Growth Hormone Nadir During Oral Glucose Tolerance Test In Adults. Eur J Endocrinol. 2019 May 1. pii: EJE-19-0139.R1. , 2828. Brick DJ, Gerweck AV, Meenaghan E, Lawson EA, Misra M, Fazeli P, et al. Determinants of IGF1 and GH across the weight spectrum: from anorexia nervosa to obesity. Eur J Endocrinol. 2010;163(2):185-91. ) |
Fasting |
↑ |
↓ |
Decreased metabolic clearance of GH, hepatic GH resistance. |
( 5555. Smith WJ, Underwood LE, Clemmons DR. Effects of caloric or protein restriction on insulin-like growth factor-I (IGF-I) and IGF-binding proteins in children and adults. J Clin Endocrinol Metab. 1995;80(2):443-9. , 8181. Moller L, Dalman L, Norrelund H, Billestrup N, Frystyk J, Moller N, et al. Impact of fasting on growth hormone signaling and action in muscle and fat. J Clin Endocrinol Metab. 2009;94(3):965-72. ) |
Malnutrition |
↑ |
↓ |
Decreased IGF-I secretion, lack of IGF-I feedback and, thus, increased GH secretion. |
( 5656. Bartz S, Mody A, Hornik C, Bain J, Muehlbauer M, Kiyimba T, et al. Severe acute malnutrition in childhood: hormonal and metabolic status at presentation, response to treatment, and predictors of mortality. J Clin Endocrinol Metab. 2014;99(6):2128-37. ) |
Anorexia nervosa |
↑ |
↓ |
Hepatic GH-resistance, reduced IGF-I bioactivity. |
( 2828. Brick DJ, Gerweck AV, Meenaghan E, Lawson EA, Misra M, Fazeli P, et al. Determinants of IGF1 and GH across the weight spectrum: from anorexia nervosa to obesity. Eur J Endocrinol. 2010;163(2):185-91. ) |
Stress (acute) |
↑ |
↔ |
Stimulation of GH secretion. |
( 8282. Jezova D, Radikova Z, Vigas M. Growth hormone response to different consecutive stress stimuli in healthy men: is there any difference? Stress. 2007;10(2):205-11. ) |
Exercise |
↑ |
↔ |
Stimulation of GH secretion. |
( 8282. Jezova D, Radikova Z, Vigas M. Growth hormone response to different consecutive stress stimuli in healthy men: is there any difference? Stress. 2007;10(2):205-11. ) |
Sleep |
↑ |
↔ |
Increased GH secretion in slow-wave sleep (deep sleep). |
( 8383. Parker DC, Rossman LG. Human growth hormone release in sleep: nonsuppression by acute hyperglycemia. J Clin Endocrinol Metab. 1971;32(1):65-9. ) |
Glucose intake |
↓ |
↔ |
Decreased GH secretion. |
( 2626. Schilbach K, Gar C, Lechner A, Nicolay SS, Schwerdt L, Haenelt M, et al. Determinants Of The Growth Hormone Nadir During Oral Glucose Tolerance Test In Adults. Eur J Endocrinol. 2019 May 1. pii: EJE-19-0139.R1. ) |
Type 1 Diabetes mellitus |
↑ |
↔ ↓ |
Hepatic GH-resistance. |
( 5757. Giustina A, Bossoni S, Cimino A, Pizzocolo G, Romanelli G, Wehrenberg WB. Impaired growth hormone (GH) response to pyridostigmine in type 1 diabetic patients with exaggerated GH-releasing hormone-stimulated GH secretion. J Clin Endocrinol Metab. 1990;71(6):1486-90. ) |
Type 2 diabetes mellitus |
↓ |
↔ ↓ |
Hepatic GH-resistance. |
( 5858. Giustina A, Wehrenberg WB. Growth Hormone neuroregulation in diabetes mellitus. Trends Endocrinol Metab. 1994;5(2):73-8. ) |
Chronic renal failure and uremia |
↔ ↑ |
↔ ↓ |
Reduced renal GH degradation and GH resistance. IGF-I bioactivity is reduced due to elevated binding protein concentrations. |
( 5959. Kamenicky P, Mazziotti G, Lombes M, Giustina A, Chanson P. Growth hormone, insulin-like growth factor-1, and the kidney: pathophysiological and clinical implications. Endocr Rev. 2014;35(2):234-81. ) |
Liver disease |
↑ |
↓ |
Reduced IGF-I production, increased GH secretion through negative feedback mechanism and hepatic GH resistance. |
( 6161. Adamek A, Kasprzak A. Insulin-Like Growth Factor (IGF) System in Liver Diseases. Int J Mol Sci. 2018;19(5). ) |
Hypothyroidism |
↓ |
↓ |
Decreased GH secretion in long term hypothyroidism. |
( 6464. Miell JP, Taylor AM, Zini M, Maheshwari HG, Ross RJ, Valcavi R. Effects of hypothyroidism and hyperthyroidism on insulin-like growth factors (IGFs) and growth hormone- and IGF-binding proteins. J Clin Endocrinol Metab. 1993;76(4):950-5. ) |
Hyperthyroidism |
↓ |
↑ |
Decreased GH secretion. Increased IGF binding proteins and therefore reduced IGF-I bioactivity. |
( 6464. Miell JP, Taylor AM, Zini M, Maheshwari HG, Ross RJ, Valcavi R. Effects of hypothyroidism and hyperthyroidism on insulin-like growth factors (IGFs) and growth hormone- and IGF-binding proteins. J Clin Endocrinol Metab. 1993;76(4):950-5. ) |
Acute critical illness |
↑ |
↓ |
Hepatic GH-resistance. |
( 6262. Van den Berghe G, de Zegher F, Veldhuis JD, Wouters P, Awouters M, Verbruggen W, et al. The somatotropic axis in critical illness: effect of continuous growth hormone (GH)-releasing hormone and GH-releasing peptide-2 infusion. J Clin Endocrinol Metab. 1997;82(2):590-9. ) |
Systemic inflammation |
↑ |
↓ |
Hepatic GH-resistance. |
( 6363. DeBoer MD, Scharf RJ, Leite AM, Ferrer A, Havt A, Pinkerton R, et al. Systemic inflammation, growth factors, and linear growth in the setting of infection and malnutrition. Nutrition. 2017;33:248-53. ) |
Oral estrogens |
↑ |
↓ |
Hepatic GH-resistance. |
( 2626. Schilbach K, Gar C, Lechner A, Nicolay SS, Schwerdt L, Haenelt M, et al. Determinants Of The Growth Hormone Nadir During Oral Glucose Tolerance Test In Adults. Eur J Endocrinol. 2019 May 1. pii: EJE-19-0139.R1. ) |
Testosterone |
↔ (↑) |
↑ |
No changes in long-term therapy (> 6 weeks). |
( 6565. Hobbs CJ, Plymate SR, Rosen CJ, Adler RA. Testosterone administration increases insulin-like growth factor-I levels in normal men. J Clin Endocrinol Metab. 1993;77(3):776-9. ) |
Biotin intake* |
↓ |
↓ |
depends on susceptibility of specific assay used, GH and IGF-I can be falsely low. |
Personal observation (unpublished) |
Pegvisomant |
↑ ↓ ↔ |
↓ ** |
Influence of pegvisomant on GH dependent on assay used (see Table 11. Johannsson G, Bidlingmaier M, Biller BMK, Boguszewski M, Casanueva FF, Chanson P, et al. Growth Hormone Research Society perspective on biomarkers of GH action in children and adults. Endocr Connect. 2018;7(3):R126-R34. ). |
( 1111. Manolopoulou J, Alami Y, Petersenn S, Schopohl J, Wu Z, Strasburger CJ, et al. Automated 22-kD growth hormone-specific assay without interference from Pegvisomant. Clin Chem. 2012;58(10):1446-56. ) |
Pregnancy |
↑ ↔ |
↑ |
GH cross reactivity dependent on assay used (see Table 11. Johannsson G, Bidlingmaier M, Biller BMK, Boguszewski M, Casanueva FF, Chanson P, et al. Growth Hormone Research Society perspective on biomarkers of GH action in children and adults. Endocr Connect. 2018;7(3):R126-R34. ). |
( 1111. Manolopoulou J, Alami Y, Petersenn S, Schopohl J, Wu Z, Strasburger CJ, et al. Automated 22-kD growth hormone-specific assay without interference from Pegvisomant. Clin Chem. 2012;58(10):1446-56. ) |