Low-dose growth hormone in adult home parenteral nutrition-dependent short bowel syndrome patients: a positive study.

Abstract

BACKGROUND & AIMS:

Controversy surrounds a 3-week treatment with a high-dose (0.14 mg. kg(-1). day(-1)) growth hormone (GH), glutamine, and high carbohydrate diet in home parenteral nutrition (HPN)-dependent patients with short-bowel syndrome (SBS). This study assessed treatment with low-dose GH in these patients.

METHODS:

Twelve adult HPN-dependent (duration, 7 +/- 1 years; mean +/- SEM) patients with SBS (small-bowel remnant length, 48 +/- 11 cm) who were on an unrestricted hyperphagic diet were randomized in a double-blind, placebo-controlled, crossover study. Patients received daily low-dose GH (0.05 mg. kg(-1). day(-1)) and placebo for two 3-week periods separated by a 1-week washout period. Net intestinal absorption of macronutrients was assessed using a duplicate diet; nutritional assessment and blood tests were performed. Data from each group were compared using Wilcoxon rank sum test.

RESULTS:

Treatment with GH increased intestinal absorption of energy (15% +/- 5%, P < 0.002), nitrogen (14% +/- 6%, P < 0.04), carbohydrates (10% +/- 4%, P < 0.04), and fat (12% +/- 8%, NS). The increased food absorption represented 37% +/- 16% of total parenteral energy delivery. Body weight (P < 0.003), lean body mass (P < 0.006), D-xylose absorption (P < 0.02), insulin-like growth factor 1 (P < 0.002), and insulin-like growth factor binding protein 3 (P < 0.002) increased, whereas uptake of GH binding protein decreased (P < 0.01), without any major adverse effect.

CONCLUSIONS:

Three weeks of low-dose GH significantly improved intestinal absorption in HPN-dependent SBS patients who were on a hyperphagic western diet.

• Authors: David Seguy, Kouroche Vahedi, Nathalie Kapel, Jean-Claude Souberbielle, Bernard Messing
• Journal: Gastroenterology (Gastroenterology) Vol. 124 Issue 2 Pg. 293-302 (Feb 2003) ISSN: 0016-5085 [Print] United States
• PMID: 12557135 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Dietary Carbohydrates
• Fats
• Insulin-Like Growth Factor Binding Protein 3
• Receptors, Somatotropin
• Growth Hormone
• Xylose
• Nitrogen

Topics

• Adult
• Body Composition
• Body Weight
• Cross-Over Studies
• Diet
• Dietary Carbohydrates (metabolism)
• Dose-Response Relationship, Drug
• Energy Metabolism (drug effects)
• Fats (metabolism)
• Female
• Growth Hormone (administration & dosage)
• Humans
• Insulin-Like Growth Factor Binding Protein 3 (metabolism)
• Intestinal Absorption (drug effects)
• Male
• Middle Aged
• Nitrogen (metabolism)
• Parenteral Nutrition, Home
• Prospective Studies
• Receptors, Somatotropin (metabolism)
• Short Bowel Syndrome (metabolism, pathology, therapy)
• Xylose (pharmacokinetics)