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GH secretion approximately doubles during puberty in boys and girls in the basal state or after stimulation but decreases after pubertal development. Remarkably, peak values after hexarelin, a 6–amino acid GH-releasing peptide (or GH secretagogue) stimulates as much GH secretion in prepuberty as in puberty. The greater elevation in girls starts at an earlier age and pubertal stage than in boys due to the earlier onset of puberty in girls. GH secretion increases coincident with the onset of breast development (Tanner stage 2) and is maximal at Tanner stage 3 to 4 breast development; in boys, GH rises later and peaks at stage 4 genital development. GH secretion and IGF-1 levels decrease after late puberty in both sexes. Adolescents of normal height have an inverse relationship between weight and GH levels. Increased GH pulse amplitude and content of GH secreted per pulse (not but frequency, metabolic clearance rate, or intersecretory burst interval and half-life of GH) in the basal state are mainly responsible for the augmented GH levels.

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