GHR and metabolic disease: GH has profound effects on regulating growth, metabolism, immunity, homeostatic processes, and aging.5–8 It functions by directly binding to its membrane receptor (GHR) that activates several signaling cascades and exerts the pleiotropic effects synergistically with or independent of insulin-like growth factor 1 (IGF1).7 The impaired GH signaling is considered to cause many metabolic diseases.