DEVELOPMENT OF CHILDREN AND ADOLESCENTS - PHYSIOLOGICAL, PATHOPHYSIOLOGICAL, AND THERAPEUTIC ASPECTS

Luteinizing hormone (LH) secretion is pulsatile with nocturnal augment ation even in prepubertal children, though at very low concentrations. With puberty wake-time, LH concentration increases 100-fold. Rising e stradiol levels transiently increase growth hormone (GH) concentration s, which in turn leads to increases in insulin-like growth factor (IGF )-I, insulin resistance, and physiological hyper-insulinemia. In addit ion to estrogens, GH-IGF are important in accretion of bone mineral de nsity (BMD) in puberty, and hypofunction may cause permanent low bone density. Growth hormone treatment of girls with Turner syndrome increa ses final height.