, we have recently shown that plasma NT-proCNP is strongly correlated with skeletal growth and markers of bone formation and is reversibly reduced by glucocorticoids. The effects on CNP of other catabolic or anabolic factors, known to affect skeletal growth, are unknown. Accordingly, we have studied the response of plasma CNP forms to acute catabolic (caloric restriction) and anabolic [growth hormone (GH) stimulation] interventions in lambs and related the findings to circulating IGF-I levels, growth velocity, and markers of bone formation. Lambs fed a reduced caloric intake (25% of normal) for 6 days exhibited reduced live weight, plasma urea, and IGF-I (P Ͻ 0.001 for all) compared with control lambs. Basal levels of NT-proCNP (40.1 Ϯ 0.9 pmol/l) fell promptly to a nadir (28.1 Ϯ 0.8 pmol/l, P Ͻ 0.001) on day 6, returning rapidly to basal levels upon refeeding. Although plasma alkaline phosphatase (ALP) fell (P Ͻ 0.001), reductions in metacarpal growth velocity were not significant within the 12-day period of study. In contrast to caloric restriction, long-acting bovine recombinant GH (2.5 mg/kg on days 0 and 6), as expected, increased plasma IGF-I more than twofold above control for 12 days (P Ͻ 0.001). Growth velocity did not differ during the 30 days of observation, and, consistent with unchanged growth velocity, plasma NT-proCNP and ALP were also unaffected. In conclusion, CNP synthesis and markers of bone formation are acutely sensitive to catabolism but unaffected by doses of GH that fail to stimulate skeletal growth. skeleton; bone growth; malnutrition; growth hormone; insulin-like growth factor I; amino-terminal pro-C-type natriuretic peptide IN CONTRAST TO THE CIRCULATING CARDIAC HORMONES atrial natriuretic peptide and B-type natriuretic peptide, C-type natriuretic peptide (CNP) acts locally in a variety of tissues, and its sites of synthesis are more diverse (10). Among others, CNP is synthesized in vascular endothelial, brain, and reproductive tissues and in skeletal tissue. In bone, the CNP signaling pathway is essential to endochondral bone growth as shown in both rodents (9) and humans (1). In keeping with its mainly paracrine action, transorgan CNP gradients are low (8) and plasma concentrations are barely detectable in normal health (7,15,17,34). Together these facts greatly limit study of the hormone's regulation and role in vivo. With the use of a novel marker of CNP synthesis [amino-terminal pro-CNP (NTproCNP); see Ref. 29], readily measurable in human and ovine plasma, we have shown recently that this stable product of the CNP gene is strongly correlated with skeletal growth and markers of bone formation (30). Furthermore, plasma NTproCNP levels, along with linear growth and markers of bone formation, are rapidly and reversibly reduced by short-term glucocorticoid administration (30). As well as indicating that CNP synthesis is subject to day-to-day regulation, these findings serve to validate the use of NT-proCNP in studies of the growing skeleton.The potential of other catabolic (11, 16) or...