Protein and Energy Metabolism with Biosynthetic Human Growth Hormone in Patients on Full Intravenous Nutritional Support

Ponting, G. A.; Ward, Humphry; Halliday, D.; Sim, A. J. W.

doi:10.1177/0148607190014005437

Cited by 43 publications

(5 citation statements)

References 21 publications

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“…The results of this study demonstrated that the effect of IGF-I on nitrogen balance could be recognised within 1 day under normoxic conditions, while it required 2 days under hypoxic conditions. In contrast, a positive nitrogen balance after 1 week of treatment with IGF-I was reported in a previous human study [25].…”

Section: Discussionmentioning

confidence: 53%

Effects of insulin-like growth factor on nitrogen balance during hypoxic exposure

Iioka¹,

Sugito²,

Moriya³

et al. 2002

Eur Respir J

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Acute exacerbations of chronic obstructive pulmonary disease (COPD) accompanied with hypoxaemia may induce net protein catabolism and hypoxaemia could be an important trigger of a systemic catabolic response. The aim of this study was to examine the anabolic effects of recombinant human insulin-like growth factor-I (IGF-I) in rats exposed to hypoxia. Although acute hypoxia is usually accompanied with a decrease in dietary intake, the usual nitrogen intake was maintained in this study.Sprague-Dawley rats were maintained by continuous infusion of solution for total parenteral nutrition for 6 days. The animals were then randomly assigned to a normoxic (N) or a hypoxic (H) group. During the last 3 days of the experiment N and H rats were randomised to receive either IGF-I or vehicle.Exposure to hypoxia caused a decrease in body-weight gain accompanied by a negative nitrogen balance, which was mainly due to increased urinary nitrogen excretion. No effect of recombinant human IGF-I treatment on body weight was observed during exposure to hypoxia, although nitrogen balance normalised.The co-infusion of recombinant human insulin-like growth factor-1 and total parenteral nutrition has a significant net anabolic effect, as demonstrated by nitrogen retention and reduction in urine protein excretion observed in rats. Insulin-like growth factor-1 may help to ameliorate the protein catabolism observed under hypoxic conditions.

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Section: Discussionmentioning

confidence: 53%

Effects of insulin-like growth factor on nitrogen balance during hypoxic exposure

Iioka¹,

Sugito²,

Moriya³

et al. 2002

Eur Respir J

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“…Therefore, we think that the lack of functional benefit observed in our study is probably not due to an insufficient increment in IGF-1 levels. The duration of the treatment does not seem too short in our study, as a positive nitrogen balance is known to occur already after 1 wk of treatment (37). Thus, although nitrogen balance was not measured in our study, it is likely that our patients treated by rhGH presented a positive nitrogen balance, as suggested by the increase in lean body mass.…”

Section: Possible Mechanisms Underlying the Observed Effectsmentioning

confidence: 74%

Administration of Growth Hormone to Underweight Patients with Chronic Obstructive Pulmonary Disease

Burdet

Muralt

Schütz

et al. 1997

Am J Respir Crit Care Med

199

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Patients with chronic obstructive pulmonary disease (COPD) often develop weight loss, which is associated with increased mortality. Recombinant human growth hormone (rhGH) treatment has been proposed to improve nitrogen balance and to increase muscle strength in these patients. The aim of this study was to assess the effects of rhGH administration on the nutritional status, resting metabolism, muscle strength, exercise tolerance, dyspnea, and subjective well-being of underweight patients with stable COPD. Sixteen patients attending a pulmonary rehabilitation program (age: 66 +/- 9 yr; weight: 77 +/- 7% of ideal body weight; FEV1: 39 +/- 13% of predicted) were randomly treated daily with either 0.15 IU/kg rhGH or placebo during 3 wk in a double-blind fashion. Measurements were made at the beginning (DO) and at the end (D21) of treatment and 2 mo later (D81). Body weight was similar in the two groups during the study, but lean body mass was significantly higher in the rhGH group at D21 (p < 0.01) and D81 (p < 0.05). The increase in lean body mass was 2.3 +/- 1.6 kg in the rhGH group and 1.1 +/- 0.9 kg in the control group at D21 and 1.9 +/- 1.6 kg in the rhGH group and 0.7 +/- 2.1 kg in the control group at D81. At D21, the resting energy expenditure was increased in the rhGH group (107.8% of DO, p < 0.001 compared with the control group). At D21 and D81, the changes in maximal respiratory pressures, handgrip strength, maximal exercise capacity, and subjective well-being were similar in the two groups. At D21, the 6-min walking distance decreased in the rhGH group (-13 +/- 31%) and increased in the control group (+10 +/- 14%; p < 0.01). We conclude that the daily administration of 0.15 IU/kg rhGH during 3 wk increases lean body mass but does not improve muscle strength or exercise tolerance in underweight patients with COPD.

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“…Recent studies with recombinant growth hormone have shown that supraphysiological doses promote positive nitrogen balance in many groups: patients with burns,'0 postoperative patients," 12 the critically ill,'3 those with chronic lung disease,'4 those receiving parenteral nutrition,'5 16 and healthy volunteers treated with steroids. " The daily dose of growth hormone used in these studies was 0-12-0-40 U/kg body weight, equivalent to two to five times that used to treat growth hormone deficiency.…”

mentioning

confidence: 99%

Avoiding autocannibalism.

Ross¹,

Miell²,

Buchanan³

1991

BMJ

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Protein and Energy Metabolism with Biosynthetic Human Growth Hormone in Patients on Full Intravenous Nutritional Support

Cited by 43 publications

References 21 publications

Effects of insulin-like growth factor on nitrogen balance during hypoxic exposure

Effects of insulin-like growth factor on nitrogen balance during hypoxic exposure

Administration of Growth Hormone to Underweight Patients with Chronic Obstructive Pulmonary Disease

Avoiding autocannibalism.

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