Effect of recombinant human growth hormone on catabolic hormones and free fatty acids following thermal injury

R. Y D Fleming, R. L. Rutan, F. Jahoor, R. E. Barrow, R. R. Wolfe, David Herndon

Research output: Contribution to journalArticle

58 Citations (Scopus)

Abstract

Severe burn injury elicits the release of catabolic hormones that contribute to negative nitrogen balance, protein wasting, and impaired wound healing. Previous studies have shown that burn patients receiving recombinant human growth hormone (rhGH) therapy have an increase in the rate of skin donor site healing and a shorter hospital stay. The mechanism by which rhGH exerts its effects, however, is not clearly understood. This study examines the effects of rhGH on circulating levels of catabolic hormones and nonesterified fatty acids in pediatric burn patients. Patients with >40% total body surface area burn were randomly assigned to receive placebo (n = 8) or 0.2 mg/kg/day rhGH (n = 6) throughout their hospitalization. All patients had early morning blood samples assessed for catecholamines (CAT), cortisol, insulin, glucagon, and free fatty acid (FFA) levels during a period of hypermetabolism. No differences could be demonstrated in age, burn size, postburn day of evaluation, resting energy expenditure per kilogram, respiratory rate, heart rate, respiratory quotient, serum cortisol, and serum glucose between placebo-and rhGH-treated patients. The rhGH-treated group did show a significant elevation (p < 0.05) in insulin-like growth factor-1 (55.9 ± 14.5 vs. 168 ± 23.7 mU/mL), total catecholamines (1,817 ± 177 vs. 1,117 ± 137 pg/mL), norepinephrine (1,257 ± 121 vs. 867 ± 113 pg/mL), epinephrine (385 ± 175 vs. 147 ± 36 pg/mL), insulin (32.8 ± 3.3 vs. 25.0 ± 3.0 mU/mL), glucagon (215 ± 18 vs. 158 ± 22 pg/mL), and free fatty acids (0.74 ± 0.01 vs. 0.59 ± 0.04 mEq/L) compared with the placebo group (data expressed as mean ± SE). Data indicate that insulin resistance and resultant hyperinsulinemia caused by rhGH therapy may lead to an increase in catecholamines, glucagon, and FFAs. The anabolic effects of rhGH, insulin, and IGF-1 appear to attenuate detrimental 'stress catabolism' and may be beneficial in the care of critical burn injuries.

Original languageEnglish (US)
Pages (from-to)698-703
Number of pages6
JournalJournal of Trauma
Volume32
Issue number6
StatePublished - 1992

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Human Growth Hormone
Nonesterified Fatty Acids
Growth Hormone
Hot Temperature
Hormones
Wounds and Injuries
Glucagon
Catecholamines
Placebos
Insulin
Hydrocortisone
Anabolic Agents
Body Surface Area
Hyperinsulinism
Somatomedins
Critical Care
Respiratory Rate
Serum
Insulin-Like Growth Factor I
Wound Healing

ASJC Scopus subject areas

  • Surgery

Cite this

Fleming, R. Y. D., Rutan, R. L., Jahoor, F., Barrow, R. E., Wolfe, R. R., & Herndon, D. (1992). Effect of recombinant human growth hormone on catabolic hormones and free fatty acids following thermal injury. Journal of Trauma, 32(6), 698-703.

Effect of recombinant human growth hormone on catabolic hormones and free fatty acids following thermal injury. / Fleming, R. Y D; Rutan, R. L.; Jahoor, F.; Barrow, R. E.; Wolfe, R. R.; Herndon, David.

In: Journal of Trauma, Vol. 32, No. 6, 1992, p. 698-703.

Research output: Contribution to journalArticle

Fleming, RYD, Rutan, RL, Jahoor, F, Barrow, RE, Wolfe, RR & Herndon, D 1992, 'Effect of recombinant human growth hormone on catabolic hormones and free fatty acids following thermal injury', Journal of Trauma, vol. 32, no. 6, pp. 698-703.
Fleming RYD, Rutan RL, Jahoor F, Barrow RE, Wolfe RR, Herndon D. Effect of recombinant human growth hormone on catabolic hormones and free fatty acids following thermal injury. Journal of Trauma. 1992;32(6):698-703.
Fleming, R. Y D ; Rutan, R. L. ; Jahoor, F. ; Barrow, R. E. ; Wolfe, R. R. ; Herndon, David. / Effect of recombinant human growth hormone on catabolic hormones and free fatty acids following thermal injury. In: Journal of Trauma. 1992 ; Vol. 32, No. 6. pp. 698-703.
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abstract = "Severe burn injury elicits the release of catabolic hormones that contribute to negative nitrogen balance, protein wasting, and impaired wound healing. Previous studies have shown that burn patients receiving recombinant human growth hormone (rhGH) therapy have an increase in the rate of skin donor site healing and a shorter hospital stay. The mechanism by which rhGH exerts its effects, however, is not clearly understood. This study examines the effects of rhGH on circulating levels of catabolic hormones and nonesterified fatty acids in pediatric burn patients. Patients with >40{\%} total body surface area burn were randomly assigned to receive placebo (n = 8) or 0.2 mg/kg/day rhGH (n = 6) throughout their hospitalization. All patients had early morning blood samples assessed for catecholamines (CAT), cortisol, insulin, glucagon, and free fatty acid (FFA) levels during a period of hypermetabolism. No differences could be demonstrated in age, burn size, postburn day of evaluation, resting energy expenditure per kilogram, respiratory rate, heart rate, respiratory quotient, serum cortisol, and serum glucose between placebo-and rhGH-treated patients. The rhGH-treated group did show a significant elevation (p < 0.05) in insulin-like growth factor-1 (55.9 ± 14.5 vs. 168 ± 23.7 mU/mL), total catecholamines (1,817 ± 177 vs. 1,117 ± 137 pg/mL), norepinephrine (1,257 ± 121 vs. 867 ± 113 pg/mL), epinephrine (385 ± 175 vs. 147 ± 36 pg/mL), insulin (32.8 ± 3.3 vs. 25.0 ± 3.0 mU/mL), glucagon (215 ± 18 vs. 158 ± 22 pg/mL), and free fatty acids (0.74 ± 0.01 vs. 0.59 ± 0.04 mEq/L) compared with the placebo group (data expressed as mean ± SE). Data indicate that insulin resistance and resultant hyperinsulinemia caused by rhGH therapy may lead to an increase in catecholamines, glucagon, and FFAs. The anabolic effects of rhGH, insulin, and IGF-1 appear to attenuate detrimental 'stress catabolism' and may be beneficial in the care of critical burn injuries.",
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