Recombinant human growth hormone enhances the metabolic efficacy of parenteral nutrition: a double-blind, randomized controlled study
| Autor: | Michael Marano, Lorraine S. Young, Yuman Fong, Douglas W. Wilmore, Thomas R. Ziegler, John L. Rombeau, Stephen F. Lowry |
|---|---|
| Rok vydání: | 1992 |
| Předmět: |
Adult
Male Parenteral Nutrition medicine.medical_specialty Resuscitation Calorie Randomization Adolescent Gastrointestinal Diseases Nitrogen Injections Subcutaneous Endocrinology Diabetes and Metabolism Sodium medicine.medical_treatment Clinical Biochemistry Peripheral edema chemistry.chemical_element Biochemistry law.invention Endocrinology Double-Blind Method Randomized controlled trial law Internal medicine medicine Humans Prospective Studies Insulin-Like Growth Factor I Saline Aged Aged 80 and over business.industry Biochemistry (medical) Pancreatic Diseases Middle Aged Recombinant Proteins Cholesterol Parenteral nutrition chemistry Growth Hormone Potassium Female medicine.symptom business |
| Zdroj: | The Journal of Clinical Endocrinology & Metabolism. |
| ISSN: | 1945-7197 |
| Popis: | This multicenter, randomized, double-blind study was performed to investigate whether recombinant GH improves the efficacy of total parenteral nutrition (TPN). Fifteen stable patients requiring parenteral feeding due to gastrointestinal/pancreatic disease were studied. Constant maintenance TPN providing approximately 30 kcal/kg day and approximately 1.6 g protein/kg.day was administered during an initial 7-day baseline period. After randomization, daily sc injections of saline (control, n = 9) or GH (10 mg/day, n = 6) were administered a 14-day treatment period as nutrient intake remained constant. Elemental balances for nitrogen (N), potassium (K), phosphorus (P), and sodium (Na) were determined daily and serial blood indices, vital signs, and other clinical parameters were monitored. Nutrient balances approached equilibrium during the baseline week in both groups. With GH administration, a significant increase in N, K, and P balance occurred; in contrast, nutrient balances did not change significantly from baseline values in control patients. The cumulative change (delta) in nutrient balances from the baseline week was also significantly greater in the GH-treated patients (delta N: control+2 +/- 7 g vs. GH+36 +/- 6. g, P less than 0.005; delta K:+57 +/- 45 mmol vs.+199 +/- 19 mmol, P less than 0.03; delta P: -27 +/- 30 mmol vs. +91 +/- 69 mmol, P less than 0.02). Plasma insulin-like growth factor-I concentrations rose 5-fold and serum cholesterol rose slightly with GH; no other significant change in group mean blood values occurred. One patient receiving GH and chronic prednisone therapy developed moderate hyperglycemia and mild peripheral edema; no other deleterious effects attributable to GH were observed. GH was well tolerated and significantly enhanced nutrient retention compared to standard parenteral feeding alone. GH improves the efficacy of parenteral nutrient utilization in patients requiring TPN. |
| Databáze: | OpenAIRE |
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