Growth hormone (GH) affects bone size and mass in part through stimulating insulin-like growth factor type 1 (IGF-1) production in liver and bone. Whether GH acts independent of IGF-1 in bone remains unclear. To define the mode of GH action in bone, we have used a Cre/loxP system in which the type 1 IGF-1 receptor (Igf1r) has been disrupted specifically in osteoblasts in vitro and in vivo. Calvarial osteoblasts from mice homozygous for the floxed IGF-1R allele (IGF-1R flox/flox ) were infected with adenoviral vectors expressing Cre. Disruption of IGF-1R mRNA (>90%) was accompanied by near elimination of IGF-1R protein but retention of GHR protein. GH-induced STAT5 activation was consistently greater in osteoblasts with an intact IGF-1R. Osteoblasts lacking IGF-1R retained GH-induced ERK and Akt phosphorylation and GH-stimulated IGF-1 and IGFBP-3 mRNA expression. GH-induced osteoblast proliferation was abolished by Cre-mediated disruption of the IGF-1R or co-incubation of cells with an IGF-1-neutralizing antibody. By contrast, GH inhibited apoptosis in osteoblasts lacking the IGF-1R. To examine the effects of GH on osteoblasts in vivo, mice wild type for the IGF-1R treated with GH subcutaneously for 7 days showed a doubling in the number of osteoblasts lining trabecular bone, whereas osteoblast numbers in similarly treated mice lacking the IGF-1R in osteoblasts were not significantly affected. These results indicate that although direct IGF-1R-independent actions of GH on osteoblast apoptosis can be demonstrated in vitro, IGF-1R is required for anabolic effects of GH in osteoblasts in vivo.The process of osteogenesis and remodeling of the skeleton is orchestrated by a constellation of local growth factors, cytokines, and systemic hormones (1, 2), of which growth hormone (GH) 2 and insulin-like growth factor type 1 (IGF-1) are key components. GH belongs to a family of cytokine peptides (3) and is produced and stored by somatotroph cells within the anterior pituitary. GH actions are mediated by binding to the transmembrane GHR, thereby triggering increased association with and activation of Janus kinases (JAKs) (4 -6) to activate signal transducers and activators of transcription (STATs) (7-15), phosphatidylinositol 3-kinase/Akt (16,17),. Growth hormone exerts many, but not all (21), of its effects by stimulation of IGF-1 from liver and peripheral tissues. IGF-1 is a small polypeptide with homology to pro-insulin that is produced by a number of cell types. IGF-1 signals via the type 1 IGF-1 receptor (IGF-1R), engaging ERK and phosphatidylinositol 3-kinase pathways through Src homology 2 domain-containing proteins and insulin receptor substrates-1 and 2 (22, 23). The effects of IGF-1 on bone have been well documented. IGF-1 has been shown to induce proliferation of MC3T3 osteoblast-like cells (24) and is an important survival factor for many mammalian cell types, including osteoblasts. IGF-1 production increases during the initial phases of fetal rat calvarial osteoblast differentiation in vitro and then declines wi...