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World J Gastroenterol. Jan 21, 2007; 13(3): 452-456
Published online Jan 21, 2007. doi: 10.3748/wjg.v13.i3.452
Short-term application of low-dose growth hormone in surgical patients: Effects on nitrogen balance and blood glucose
Ming-Ming Zhang, Xiao-Ting Wu, Yong Zhou, Kun Qian, Ya-Min Zheng
Ming-Ming Zhang, Xiao-Ting Wu, Yong Zhou, Kun Qian, Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Ya-Min Zheng, Department of General Surgery, Xuanwu Hospital, Capital University of Medical Sciences, Beijing 100053, China
Author contributions: All authors contributed equally to the work.
Correspondence to: Professor Xiao-Ting Wu, Department of General Surgery, West China Hospital, Sichuan University, 37 Guo Xue Rd., Chengdu 610041, Sichuan Province, China. wawjwj_100@163.com
Telephone: +86-28-66839171 Fax: +86-28-85422483
Received: October 14, 2006
Revised: November 10, 2006
Accepted: December 9, 2006
Published online: January 21, 2007
Abstract

AIM: To investigate the effectiveness and safety of recombinant human growth hormone (rhGH) in postoperative patients.

METHODS: A total of 48 consecutive patients undergoing abdominal operations were randomized to receive either subcutaneous rhGH (0.15 IU/kg) or placebo (menstruum) injections daily for 7 d after surgery. The two groups had similar nutritional intake. Blood samples for serum fibronectin, albumin, prealbumin, transferrin and the total lymphocyte count, as well as glucose levels were collected to study the rhGH effect. Basal laboratory evaluation, and nutritional status were estimated on d 1 before as baseline and d 3 and 10 after operation using standard laboratory techniques. Nitrogen balance was measured from d 3 to 9 after operation.

RESULTS: The cumulative nitrogen balance was significantly improved in rhGH group compared with the placebo group (11.37 ± 16.82 vs -9.11 ± 17.52, P = 0.0003). Serum fibronectin was also significantly higher in the rhGH group than in the placebo group (104.77 ± 19.94 vs 93.03 ± 16.03, P < 0.05), whereas changes in serum albumin, prealbumin, transferrin and total lymphocyte counts were not statistically significant. Mean blood glucose levels were significantly higher in the rhGH group from d 3 to 6 after operation.

CONCLUSION: If blood glucose can be controlled, low-dose growth hormone together with hypocaloric nutrition is effective on improving positive nitrogen balance and protein conservation and safe is in postoperative patients.

Keywords: Growth hormone; Nutritional support; Abdominal surgery; Hyperglycemia; Nitrogen balance