Hepatocyte — GH receptor and IGF-1 synthesis

Target gland or tissue · GH receptor JAK2-STAT5 IGFBP-3

GH binds its hepatic receptor and signals through JAK2 and STAT5b to transcribe IGF-1, which circulates bound to IGFBP-3 and the acid-labile subunit. That binding gives IGF-1 a long half-life and makes it the stable measure of GH output.

Traced from the start

  1. GHRH and somatostatin (arcuate and periventricular nuclei)
  2. Somatotroph — growth hormone
  3. Hepatocyte — GH receptor and IGF-1 synthesis

Detail

Why IGF-1 is measured
GH is pulsatile; IGF-1 is steady across the day and reflects integrated secretion
Requires
Adequate nutrition and insulin — malnutrition, poorly controlled diabetes, coeliac disease and liver failure lower IGF-1 despite high GH
Age dependence
IGF-1 must be read against an age-matched range: it peaks in puberty and falls with age

When it goes wrong

GH receptor mutation (Laron syndrome)

Severe short stature with high GH and low IGF-1; growth hormone is useless and recombinant IGF-1 is the treatment

Chronic liver disease or anorexia nervosa

Acquired GH resistance: high GH with low IGF-1 and poor growth in children

Practise this structure

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