Modulation of glucocorticoid metabolism by the growth hormone – IGF‐1 axis
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Summary: The growth hormone‐insulin‐like growth factor 1 (GH‐IGF‐1) axis plays an important role in modulating the peripheral metabolism of glucocorticoids mainly through its effect on the isoenzyme 11 β‐hydroxysteroid dehydrogenase 1 (11β‐HSD1) which, in vivo , functions as a reductase catalysing the conversion of cortisone to cortisol. Several in vivo and ex vivo studies have shown that the GH‐IGF‐I system inhibits the expression and activity of 11β‐HSD1 in adipose tissues and the liver resulting in reduced local regeneration of cortisol. This interaction has clinically significant implications as it may at least partly explain the phenotypes of acromegaly and adult GH deficiency and the effects that treatment of these conditions has on body composition. In addition, by accelerating the peripheral metabolism of cortisol, GH therapy may precipitate adrenal insufficiency in susceptible hypopituitary patients, and endocrinologists should be mindful of this phenomenon when starting hypopituitary patients on GH replacement therapy.
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In patients with hypopituitarism, growth hormone replacement therapy can also unmask adrenal insufficiency.
“In patients with hypopituitarism, growth hormone replacement therapy can also unmask AI.42”
From Adrenal crisis: prevention and management in adult patients (2019) · cites this paper as [42]
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<b>Urinary free cortisone and the assessment of 11β‐hydroxysteroid dehydrogenase activity in man</b>
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- Authors
- Agha, A., & Monson, J. P.
- Affiliations
- St Bartholomew's Hospital (GB)
- Corresponding author
- Agha, Amar
- Venue
- Clinical Endocrinology
- Publisher
- Wiley
- Published
- 2007-02-13
- Volume
- 66
- Issue
- 4
- Pages
- 459-465
- ISSN
- 0300-0664 (ISSN-L)
- 1365-2265
- OpenAlex
- W2069360747
- Cited by
- 108
- References
- 8
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 3 · 2023: 6 · 2022: 4 · 2021: 2 · 2020: 7 · 2019: 5 · 2018: 6 · 2017: 7 · 2016: 4 · 2015: 3 · 2014: 5 · 2013: 7 · 2012: 2
- FWCI
- 1.58
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Clinical Endocrinology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Growth Hormone and Insulin-like Growth Factors
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
- Keywords
- growth hormone, insulin-like growth factor I, glucocorticoid metabolism, 11β-hydroxysteroid dehydrogenase type 1, cortisol production, cortisone, adipose tissue, liver, acromegaly, adult growth hormone deficiency, body composition, adrenal insufficiency, hypopituitarism, growth hormone therapy
- MeSH terms
- Adrenal Insufficiency, Adrenocorticotropic Hormone, Adult, Cortisone, Humans, Hydrocortisone, Hypopituitarism, Insulin-Like Growth Factor I, Pituitary Gland, Anterior, Growth Hormone, Human Growth Hormone, 11-beta-Hydroxysteroid Dehydrogenase Type 1, Adiposity
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