Growth Hormone Therapy in Adults and Children

Growth hormone is produced by the somatotroph cells of the anterior pituitary. Its secretion is stimulated by growth hormone–releasing hormone and inhibited by somatostatin, which are both produced by the hypothalamus. Growth hormone secretion is pulsatile, and the amplitude of the pulses is greatest at night. Twenty-four-hour growth hormone secretion is maximal during puberty and declines gradually thereafter in both women and men. Growth hormone acts by binding to receptors on liver cells and other cells. One growth hormone molecule binds to two receptor molecules on the target cell, initiating a cascade of events that results in the secretion of . . .