Hypothalamic growth hormone/igf-1 axis

Abstract

Obese subjects with visceral adiposity might have multiple abnormalities along the growth hormone (GH)/insulin-like growth factor-1 (IGF-1) axis. The reciprocal relationships between GH secretion and adipose tissue depots can complicate the differential diagnosis between organic GHD and obesity-related decrease in GH secretion in obese individuals. Albeit functional and mainly reversible after weight loss, the low GH status is associated with a higher prevalence of cardiometabolic risk factors and a worse body composition compared with obese individuals with a normal GH/IGF-1 axis. The impairment of GH/IGF-1 axis might be the rationale to consider GH as an adjunctive treatment of obesity, at least in the subset of obese individuals with reduced GH secretory capacity and low circulating levels of IGF-1, in relation to their worse cardiometabolic risk profile, with particular regard to those patients who are candidates for bariatric surgery.