© 2004 BMJ Publishing Group Ltd & Association of Clinical Pathologists
EDITORIAL
Growth hormone deficiency
More guidance on growth hormone deficiency
Correspondence to:
Correspondence to:
Dr R Ayling
Department of Clinical Chemistry, Derriford Hospital, Plymouth, Devon PL6 8DH, UK; ruthayling@clinicalbiochemistry.org.uk
Is it needed?
Keywords: provocation tests; short stature; stimulation test
| The first 150 words of the full text of this article appear below. |
Growth is controlled and modulated by many factors, including nutritional, environmental, and endocrine mechanisms. During the 1st year of life, nutrition is the most important factor determining growth. Growth hormone (GH) is essential for growth throughout childhood, with sex steroids contributing to the pubertal growth spurt.
GH is released from the anterior pituitary gland under the influence of the opposing hypothalamic regulatory peptides, GH releasing hormone (GHRH) and somatostatin. The actions of GH are largely indirect, via insulin-like growth factors (IGFs), which exert negative feedback control on GH release. The GH releasing peptide ghrelin is the endogenous ligand for the GH secretagogue (GHS) receptor and induces a positive energy balance using an additional mechanism for GH control. It is produced predominantly by the stomach and appears to have a role in the integration of energy balance and growth.
GH deficiency (GHD) leads to a reduction in the
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