Question 1

What is the Meaning of Hepatic Growth Hormone Resistance?

Accepted Answer

Hepatic Growth Hormone Resistance describes a state where liver cells exhibit diminished response to circulating growth hormone, despite adequate or elevated levels. This impairment prevents the liver from properly synthesizing and releasing insulin-like growth factor 1 (IGF-1), a crucial mediator of growth hormone's anabolic and metabolic effects.

Question 2

What is the Context of Hepatic Growth Hormone Resistance?

Accepted Answer

This resistance operates within the somatotropic axis, a key endocrine system regulating growth and metabolism. The liver serves as the primary target organ for growth hormone, converting its signal into systemic IGF-1 production, which then acts on peripheral tissues. Impaired liver response disrupts this cascade, impacting bodily functions.

Question 3

What is the Significance of Hepatic Growth Hormone Resistance?

Accepted Answer

Clinically, hepatic growth hormone resistance impacts growth trajectory in childhood and metabolic health across the lifespan. Reduced IGF-1 levels lead to short stature or growth failure in pediatric patients. In adults, it may contribute to altered body composition and insulin dysregulation. Recognizing this resistance is vital for diagnosis and clinical management.

Question 4

What is the Mechanism of Hepatic Growth Hormone Resistance?

Accepted Answer

The mechanism involves defects at the growth hormone receptor or its intracellular signaling pathways within hepatocytes. Growth hormone binds to its receptor, activating the JAK-STAT pathway, leading to IGF-1 transcription. In resistance, genetic mutations, signaling molecule deficiencies, or acquired factors like inflammation interfere with this cascade, impeding IGF-1 synthesis.

Question 5

What is the Application of Hepatic Growth Hormone Resistance?

Accepted Answer

Hepatic growth hormone resistance manifests clinically, depending on its underlying cause and age of onset. In pediatric endocrinology, it is a consideration for short stature, requiring assessment of growth parameters and hormonal profiles. For adults, it might present as part of metabolic syndromes or chronic liver disease. Therapeutic strategies involve addressing the root cause or administering recombinant IGF-1.

Question 6

What is the Metric of Hepatic Growth Hormone Resistance?

Accepted Answer

Assessment of hepatic growth hormone resistance relies on biochemical markers. Findings include normal or elevated serum growth hormone concentrations coupled with low circulating insulin-like growth factor 1 (IGF-1) levels. Evaluation of insulin-like growth factor binding protein 3 (IGFBP-3) often parallels IGF-1. Dynamic testing, such as a growth hormone stimulation test, may confirm pituitary growth hormone secretion, reinforcing tissue resistance diagnosis.

Question 7

What is the Risk of Hepatic Growth Hormone Resistance?

Accepted Answer

Improper management or undiagnosed hepatic growth hormone resistance carries clinical risks. For children, the concern is persistent growth failure and failure to attain adult height, impacting well-being. In adults, chronic low IGF-1 levels may contribute to adverse metabolic profiles, including reduced lean body mass, increased adiposity, insulin resistance, and dyslipidemia, potentially increasing long-term risk of cardiovascular disease and metabolic syndrome.

Hepatic Growth Hormone Resistance

Meaning

Context

Significance

Mechanism

Application

Metric

Risk

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