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Am J Physiol Endocrinol Metab 267: E560-E565, 1994;
0193-1849/94 $5.00
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AJP - Endocrinology and Metabolism, Vol 267, Issue 4 E560-E565, Copyright © 1994 by American Physiological Society

ARTICLES

Altered lipid kinetics in adjuvant recombinant human growth hormone-treated multiple-trauma patients

M. Jeevanandam and S. R. Petersen
Trauma Center, St. Joseph's Hospital and Medical Center, Phoenix, Arizona 85013.

Adjuvant recombinant human growth hormone therapy during the postinjury period may improve the efficiency of utilization of body energy stores. In a group of 20 severely injured highly catabolic hypermetabolic adult multiple-trauma victims, we have investigated the basic lipid kinetics of trauma (study I) and its modification after 7 days of intravenous feeding (total parenteral nutrition) with (group H, n = 10) or without (group C, n = 10) daily rhGH (0.15 mg somatotropin.kg-1.day-1) intramuscular injections (study II). Whole body lipolysis rate (2-stage primed constant infusion of 10% glycerol), substrate net oxidation rates (indirect calorimetry), and plasma levels of hormones were determined. Compared with the control group (group C) the treatment group (group H) showed significantly (P = 0.006) enhanced rates of lipolysis and free fatty acid reesterification (10 +/- 2 to 18 +/- 2 kcal.kg-1.day-1, P = 0.05). As a function of resting energy expenditure (REE), a trend of increased net glucose oxidation [32 +/- 10 vs. 56 +/- 7% REE, not significant (NS)] and decreased fat (40 +/- 8 vs. 25 +/- 5% REE, NS) and protein oxidation rates (28 +/- 2 vs. 19 +/- 2% REE, P = 0.007) were also indicated. The simultaneous operation of increased lipolytic and reesterification processes may allow the adipocyte to respond rapidly to changes in peripheral metabolic fuel requirements in injury.


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J. Takala, E. Ruokonen, N. R. Webster, M. S. Nielsen, D. F. Zandstra, G. Vundelinckx, and C. J. Hinds
Increased Mortality Associated with Growth Hormone Treatment in Critically Ill Adults
N. Engl. J. Med., September 9, 1999; 341(11): 785 - 792.
[Abstract] [Full Text] [PDF]


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