title: Determinants of GH resistance in malnutrition.
abstract: States of undernutrition are characterized by GH resistance. Decreased total energy intake, as well as isolated protein-calorie malnutrition and isolated nutrient deficiencies, result in elevated GH levels and low levels of IGF1. We review various states of malnutrition and a disease state characterized by chronic undernutrition - anorexia nervosa - and discuss possible mechanisms contributing to the state of GH resistance, including fibroblast growth factor 21 and Sirtuin 1. We conclude by examining the hypothesis that GH resistance is an adaptive response to states of undernutrition, in order to maintain euglycemia and preserve energy.
authors.affiliation: Neuroendocrine Unit, Massachusetts General Hospital, 55 Fruit Street, Bulfinch 457, Boston, Massachusetts 02114, USA.
authors.forename: Pouneh K
authors.initials: PK
authors.lastname: Fazeli
authors.forename: Anne
authors.initials: A
authors.lastname: Klibanski
mesh_terms: D000856:Anorexia Nervosa / Q000378:metabolism*; D005346:Fibroblast Growth Factors / Q000378:metabolism; D019382:Human Growth Hormone / Q000378:metabolism*; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D044342:Malnutrition / Q000378:metabolism*
chemical_list: C414620:fibroblast growth factor 21; D019382:Human Growth Hormone; D005346:Fibroblast Growth Factors; D007334:Insulin-Like Growth Factor I
keywords: IGF; growth hormone; neuroendocrinology; pituitary