1. علم راهی بسوی آفریدگار جهان
Growth Hormone (GH; Somatotropin)
Dr. Radmanesh

2. Human Growth Hormone Polypeptide 191 amino acid residues
MW = daltons
Highly hydrophobic proteins

4. Regulation of GH Expression in Somatotrophs
GHRH
somatostatin AC Gs Gi
(-)
cAMP
PKA
PIT-1
GH synthesis
A txn factor in the Pit

5. Actions of Growth Hormone:
increases skeletal growth
increases muscular growth
increases amino acid uptake and protein synthesis
increased use of lipids for energy
decreased storage of carbohydrates 3

8. Feedback control of growth hormone

10. ganong
Ganong

13. Ganong

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28. Ganong

31. Amount of Growth Hormone

32. CLINICAL PICTURE OF HYPOPITUITARISM
DEPENDS ON HORMONES LOST
1. Lack of FSH LH : 
1. Hypogonadim
2. Lack of TSH:  hypothyroidism
3. Lack of ACTH:  adrenocortical insufficiency
4. Prolactin deficiency
5. If all of the above: PANHYPOPITUITARISM
6. In children: GH: short stature

33. Cause of Hypopituitarism
Shock or severe hypotension
Head trauma
Brain tumors or infection
Genetic considerations

34. What Causes this Disorder?
Hyposecretion (underproduction) of the Growth Hormone during growing years causes slow bone growth and the epiphyseal plates close before normal height is reached. This condition is known as Dwarfism.

35. Laron dwarfs, who lack normal GH receptors but have normal GH secretion.

36. Care Replacement of deficient hormones Androgen therapy
Estrogens and progesterone
Growth hormone

37. Hyperpituitarism
Hormone oversecretion occurs with pituitary tumors or hyperplasia
Genetic considerations
Pituitary adenoma

39. Gigantism
Gigantism is the onset of growth hormone hypersecretion before puberty.

40. Acromegaly

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42. Complications of Acromegaly
Cardiovascular
Ischemic heart disease
Cardiomyopathy
Congestive heart failure
Arrhythmias
Hypertension
Respiratory
Kyphosis
Metabolic
Diabetes mellitus/IGT
Hyperlipidemia

43. Patient-Centered Collaborative Care
Assessment
Nonsurgical management:
Drug therapy- to reduce GH secretion or the effects on tissues
Somatostatin analogues
Dopamine agonists
Growth hormone antagonist
Radiation
Gamma knife procedure
Usually one time treatment

44. Surgical Management

45. Pituitary Surgery