Effects of therapy with recombinant human growth hormone on insulin-like growth factor system components and serum levels of biochemical markers of bone formation in children after severe burn injury
| Autor: | G L, Klein, S E, Wolf, C B, Langman, C J, Rosen, S, Mohan, B S, Keenan, S, Matin, C, Steffen, M, Nicolai, D E, Sailer, D N, Herndon |
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| Rok vydání: | 1998 |
| Předmět: |
Male
Wound Healing Bone Development Human Growth Hormone Osteocalcin Recombinant Proteins Spine Insulin-Like Growth Factor Binding Proteins Insulin-Like Growth Factor Binding Protein 3 Double-Blind Method Insulin-Like Growth Factor Binding Protein 4 Bone Density Child Preschool Humans Female Insulin-Like Growth Factor I Burns Child Insulin-Like Growth Factor Binding Protein 5 Biomarkers |
| Zdroj: | The Journal of clinical endocrinology and metabolism. 83(1) |
| ISSN: | 0021-972X |
| Popis: | Burn injury in children is associated with low bone formation and long-term bone loss. Because recombinant human GH (rHGH) may accelerate burn wound healing, and because rHGH increases bone formation and density in GH-deficient patients, we studied the short-term effects of rHGH on bone fomation, reflected by osteocalcin and type I procollagen propeptide levels in a randomized, double-blind, placebo-controlled study. Nineteen patients were enrolled and received either rHGH (0.2 mg/kg.day) or an equal volume of saline. Mean burn size and age were not different between the groups, and test substances were given from admission to time of wound healing (mean: 43 +/- 22 days). At wound healing, serum levels of insulin-like growth factor (IGF)-1 and IGF binding protein (IGFBP)-3 in the rHGH group rose to mean values of 229% and 187% of the respective means of the placebo group (P0.025). Serum osteocalcin concentrations remained below normal in both groups, and type I procollagen propeptide levels achieved a low normal level IGFBR-4 levels were twice that of normal on admission and doubled further at wound healing; IGFBP-5 levels were low on admission but rose to normal at wound healing. We conclude that large doses of rHGH were ineffective in improving disordered bone formation despite increasing serum IGF-1 and IGFBP-3. The rHGH-independent rise in serum levels of the inhibitory binding protein IGFBP-4 suggests a mechanism by which improved bone formation is prevented despite successful elevation of IGF-1 and IGFBP-3 in the burned child. |
| Databáze: | OpenAIRE |
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