**Core Concept**
Cortisol and growth hormone (GH) are two distinct hormones with different metabolic effects. Cortisol is a glucocorticoid hormone that promotes glucose production, lipolysis, and protein catabolism, whereas GH stimulates insulin-like effects, lipogenesis, and protein synthesis.

**Why the Correct Answer is Right**
Cortisol increases gluconeogenesis and glycogenolysis, leading to elevated blood glucose levels. In contrast, GH promotes insulin-like effects by stimulating glucose uptake in peripheral tissues, thereby lowering blood glucose levels. The opposing actions of cortisol and GH on glucose metabolism are crucial for maintaining energy homeostasis.

**Why Each Wrong Option is Incorrect**
* **Option A:** Cortisol and GH have different effects on blood pressure, but this is not the most dissimilar metabolic effect between the two hormones.
* **Option B:** Cortisol and GH have distinct effects on protein metabolism, but this is not the most dissimilar effect.
* **Option C:** Cortisol and GH have different effects on lipid metabolism, but this is not the most dissimilar effect.

**Clinical Pearl / High-Yield Fact**
Cortisol and GH have opposing effects on glucose metabolism, which is essential for maintaining energy homeostasis in the body. Understanding these effects is crucial for managing various endocrine disorders.

**Correct Answer:** D. Glucose metabolism. Cortisol and GH have the most dissimilar metabolic effects on glucose metabolism.