Anabolic effects of human growth hormone and high caloric feedings following thermal injury

D. W. Wilmore, J. A. Moylan, B. F. Bristow, A. D. Mason, B. A. Pruitt

Research output: Contribution to journalArticlepeer-review

180 Scopus citations

Abstract

Human growth hormone (STH) was administered to 9 patients with burns from 34 to 76% of the total body surface, mean 54%, prior to wound coverage, while they received a fixed intake of nitrogen and calories to meet predicted metabolic requirements. A 7 day study period, while each patient received human STH, 10 i.u. per day, was compared with a similar control period randomly varied to precede or follow the study period. Increased nitrogen retention occurred with human STH therapy in all but one patient, with mean loss of urinary nitrogen, averaging 16.4 per day compared with 21.3 during the control period. Retention of potassium paralleled protein sparing, which occurred in the ratio of approximately 3:1, about that found in muscle. Blood urea nitrogen levels decreased from 17 mg per 100 ml to 13, free fatty acid levels increased from 1.0 to 2.2 mq/l and liver function tests appeared to return to normal values with human STH therapy. Glucose tolerance was unchanged, although glucose tolerance curves plateaued at higher levels, and plasma insulin response was accentuated by approximately 100%, while the patients received human STH. In the single patient receiving the least amount of human STH per kg body weight, nitrogen sparing did not occur, and the insulin response to the glucose tolerance test was unchanged from control values. Results of these studies demonstrate that human STH can preserve protoplasmic mass and improve nitrogen retention in the catabolic phase after injury. The protein sparing effect and other beneficial secondary gains of human STH, which enhance recovery of the injured patients, appeared to be dosage related, to require adequate nutrient loading, and to be mediated by alterations of carbohydrate metabolism in the presence of augmented insulin production.

Original languageEnglish (US)
Pages (from-to)875-884
Number of pages10
JournalSurgery Gynecology and Obstetrics
Volume138
Issue number6
StatePublished - Dec 1 1974

ASJC Scopus subject areas

  • Surgery
  • Obstetrics and Gynecology

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