{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T07:02:52Z","timestamp":1788850972609,"version":"build-2803163510"},"reference-count":80,"publisher":"Bioscientifica","issue":"2","content-domain":{"domain":["joe.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,5,1]]},"abstract":"<jats:p>The fact that growth hormone (GH) plays an important role in health after the cessation of growth requiring replacement therapy in adult life has only been recognised in the last three decades. This has only been made possible by recombinant technology providing GH supplies required to undertake investigations in the physiology of GH action and the benefits of replacement therapy in patients identified by rigorously validated diagnostic tests for GH deficiency (GHD). Human studies have revealed important regulatory roles in substrate metabolism, sodium homeostasis, body composition, and physical function. GH-induced anabolism is achieved by stimulating amino acid incorporation into protein while reducing oxidative loss simultaneously enhancing lipid utilisation by stimulating fatty acid oxidation and reducing lipid storage. Sodium and fluid retention are enhanced by activating the renin\u2013angiotensin system and distal renal tubular reabsorption. GH stimulates the aerobic and anaerobic energy systems that underpin muscle and cardiovascular function. These pleiotropic actions explain the clinical picture of increased adiposity, reduced lean mass, and impaired physical and psychological function in the GHD adult, all of which are reversed when GH is replaced. Women require a greater replacement dose of GH than men. This is because androgens enhance while oestrogens attenuate GH action. The oestrogen effect is route-dependent, occurring with oral delivery blunting the liver-mediated actions of GH by directly inhibiting GH receptor signalling, global experience spanning over 30 years has attested to the safety, efficacy, and benefits of replacement therapy for adults with GHD.<\/jats:p>","DOI":"10.1530\/joe-22-0197","type":"journal-article","created":{"date-parts":[[2022,12,16]],"date-time":"2022-12-16T07:45:16Z","timestamp":1671176716000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-5","source":"Crossref","is-referenced-by-count":24,"title":["The physiology of growth hormone (GH) in adults: translational journey to GH replacement therapy"],"prefix":"10.1530","volume":"257","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2508-9588","authenticated-orcid":true,"given":"Ken KY","family":"Ho","sequence":"first","affiliation":[{"name":"Garvan Institute of Medical Research, St. Vincent\u2019s Hospital and the UNSW Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony J","family":"O\u2019Sullivan","sequence":"additional","affiliation":[{"name":"St. George Hospital and the Faculty of Medicine and Health, UNSW Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morton G","family":"Burt","sequence":"additional","affiliation":[{"name":"Southern Adelaide Diabetes and Endocrine, Flinders Medical Centre and College of Medicine and Public Health, and Flinders University, Adelaide, South Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","reference":[{"key":"bib1","series-title":"Journal of Clinical Endocrinology and Metabolism","first-page":"2255","article-title":"Prevalence and incidence of diabetes mellitus in adult patients on growth hormone replacement for growth hormone deficiency: a surveillance database analysis","volume":"96","author":"Attanasio","year":"2011","unstructured":"Attanasio AFJung HMo DChanson PBouillon RHo KKLamberts SWClemmons DR & HypoCCS International Advisory Board2011Prevalence and incidence of diabetes mellitus in adult patients on growth hormone replacement for growth hormone deficiency: a surveillance database analysis. 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