Endogenous anabolic hormones and hypermetabolism

Effect of trauma and gender differences

Marc G. Jeschke, Robert E. Barrow, Ron P. Mlcak, David Herndon, Basil A. Pruitt, William G. Cioffi

Research output: Contribution to journalArticle

48 Citations (Scopus)

Abstract

Objective: Protein degradation, negative nitrogen balance and compromised structure of essential organs have been associated with resistance and decreased production of anabolic hormones. In turn, increased levels of anabolic hormones are associated with improved survival. The aims of the present study were to determine the pattern of anabolic hormones, resting energy expenditure and cytokines in severely thermally injured pediatric patients and to compare these parameters in female and male patients. Methods: Sixty-five children (1 to 16 years of age) sustaining a severe thermal injury (≥40% TBSA) were included into the study. Patients were further divided into females (n = 22) and males (n = 43). Patient demographics, nutritional support, incidence of sepsis, inhalation injury, and mortality were noted. Resting energy expenditure was measured during hospital course by indirect calorimetry. Blood was drawn 0, 10, 20, and 40 days postburn and serum insulin-like growth factor-I (IGF-I), insulin-like growth factor binding protein-1 and -3 (IGFBP-1, and -3), growth hormone, insulin, and cytokines were measured. Results: There were no significant differences between females and males for demographics, nutritional intake, or concomitant injuries. In both groups, endogenous anabolic agents were drastically decreased by 3- to 5-fold up to 40 days posttrauma. Females had significantly higher levels of IGF-I, IGFBP-3, growth hormone, and insulin when compared with males, P < 0.05. Increased levels of anabolic hormones were associated with decreased stay on the ICU (females 36 ± 22 days versus males 53 ± 39 days), decreased serum IL-1β and TNF-α as well as resting energy expenditure, P < 0.05. Conclusion: Data indicate that despite adequate nutritional support, severe thermal injury leads to decreased anabolic hormones over a prolonged period of time. Female patients had significantly increased levels of anabolic hormones, which are associated with decreased proinflammatory mediators and hypermetabolism, leading to a significant shorter ICU stay compared with male patients.

Original languageEnglish (US)
Pages (from-to)759-768
Number of pages10
JournalAnnals of Surgery
Volume241
Issue number5
DOIs
StatePublished - May 2005

Fingerprint

Hormones
Insulin-Like Growth Factor Binding Protein 3
Wounds and Injuries
Energy Metabolism
Insulin-Like Growth Factor Binding Protein 1
Nutritional Support
Insulin-Like Growth Factor I
Growth Hormone
Hot Temperature
Demography
Insulin
Cytokines
Anabolic Agents
Indirect Calorimetry
Serum
Interleukin-1
Inhalation
Proteolysis
Sepsis
Nitrogen

ASJC Scopus subject areas

  • Surgery

Cite this

Jeschke, M. G., Barrow, R. E., Mlcak, R. P., Herndon, D., Pruitt, B. A., & Cioffi, W. G. (2005). Endogenous anabolic hormones and hypermetabolism: Effect of trauma and gender differences. Annals of Surgery, 241(5), 759-768. https://doi.org/10.1097/01.sla.0000161028.43338.cd

Endogenous anabolic hormones and hypermetabolism : Effect of trauma and gender differences. / Jeschke, Marc G.; Barrow, Robert E.; Mlcak, Ron P.; Herndon, David; Pruitt, Basil A.; Cioffi, William G.

In: Annals of Surgery, Vol. 241, No. 5, 05.2005, p. 759-768.

Research output: Contribution to journalArticle

Jeschke, MG, Barrow, RE, Mlcak, RP, Herndon, D, Pruitt, BA & Cioffi, WG 2005, 'Endogenous anabolic hormones and hypermetabolism: Effect of trauma and gender differences', Annals of Surgery, vol. 241, no. 5, pp. 759-768. https://doi.org/10.1097/01.sla.0000161028.43338.cd
Jeschke, Marc G. ; Barrow, Robert E. ; Mlcak, Ron P. ; Herndon, David ; Pruitt, Basil A. ; Cioffi, William G. / Endogenous anabolic hormones and hypermetabolism : Effect of trauma and gender differences. In: Annals of Surgery. 2005 ; Vol. 241, No. 5. pp. 759-768.
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