Since its discovery nearly a century ago, over 100,000 studies of growth hormone (GH) have investigated its structure, how it interacts with the GH receptor and its multiple actions. These include effects on growth, substrate metabolism, body composition, bone mineral density, the cardiovascular system and brain function, among many others. Recombinant human GH is approved for use to promote growth in children with GH deficiency (GHD), along with several additional clinical indications. Studies of humans and animals with altered levels of GH, from complete or partial GHD to GH excess, have revealed several covert or hidden actions of GH, such as effects on fibrosis, cardiovascular function and cancer. In this Review, we do not concentrate on the classic and controversial indications for GH therapy, nor do we cover all covert actions of GH. Instead, we stress the importance of the relationship between GH and fibrosis, and how fibrosis (or lack thereof) might be an emerging factor in both cardiovascular and cancer pathologies. We highlight clinical data from patients with acromegaly or GHD, alongside data from cellular and animal studies, to reveal novel phenotypes and molecular pathways responsible for these actions of GH in fibrosis, cardiovascular function and cancer.

自近一个世纪前发现它以来，已有超过 100,000 项关于生长激素 (GH) 的研究调查了它的结构、它如何与 GH 受体相互作用及其多种作用。其中包括对生长、底物代谢、身体成分、骨矿物质密度、心血管系统和大脑功能等的影响。重组人 GH 被批准用于促进生长激素缺乏症 (GHD) 儿童的生长，以及其他一些临床适应症。对 GH 水平改变（从完全或部分 GHD 到 GH 过量）的人类和动物的研究揭示了 GH 的几种隐蔽或隐藏的作用，例如对纤维化、心血管功能和癌症的影响。在这篇综述中，我们不关注 GH 治疗的经典和有争议的适应症，也不涵盖 GH 的所有隐蔽作用。反而，我们强调 GH 与纤维化之间关系的重要性，以及纤维化（或缺乏纤维化）如何可能成为心血管和癌症病理学中的一个新兴因素。我们重点介绍肢端肥大症或 GHD 患者的临床数据，以及细胞和动物研究的数据，以揭示导致 GH 在纤维化、心血管功能和癌症中的这些作用的新表型和分子途径。