Effect of parenteral nutrition on the blood levels of insulin, glucagon, growth hormone, thyroid hormones and cortisol in catabolic patients.
The changes in plasma insulin (IRI) glucagon (IRG), IRI:IRG ration, growth hormone (HGH), cortisol and thyroid hormones during two different but isocaloric parenteral nutrition regimens were investigated in 11 malnourished patients and 21 postoperative patients. The nutrition program which used glucose as a non-nitrogen energy source favoured anabolism by a higher rise in plasma IRI and by a higher rise in the initially low plasma IRI:IRG ratio in both malnourished and postoperative patients more than the alimentation regimen with glucose and lipid. The glucose program augmented the IRI:IRG ratio to an average of 5.5 +/- 1.2 (SEM) in malnourished patients and to 8.4+/-2.7 in postoperative patients. The corresponding values for the glucose-lipid program were 3.9+/- 1.0 and 1.9 +/- 0.4. In malnourished patients the difference between the anabolic effect of these nutrition regimens was further increased by a fall in the plasma HGH level to 0.7 +/- 0.3 microgram/l during fat infusion. Over a period of four days both alimentation programs similarly increased in the initially low serum T3 and free T3 index to the normal reference interval and decreased serum rT3 to a subnormal level (0.18+/-0.7 nmol/l) in malnourished patients. In postoperative patients the only change in thyroid hormones which was dependent on the four-day parenteral nutrition was the decrease in the initially elevated serum rT3 to the normal reference interval by both alimentation programs (by 54% in the glucose and by 30% in the glucose-lipid program).
D000328:Adult; D000368:Aged; D005260:Female; D005934:Glucagon / Q000097:blood; D005947:Glucose / Q000008:administration & dosage; D013006:Growth Hormone / Q000097:blood; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007328:Insulin / Q000097:blood; D008055:Lipids / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009748:Nutrition Disorders / Q000097:blood* / Q000628:therapy; D010288:Parenteral Nutrition; D010289:Parenteral Nutrition, Total; D011184:Postoperative Period; D013963:Thyroid Hormones / Q000097:blood
D007328:Insulin; D008055:Lipids; D013963:Thyroid Hormones; D013006:Growth Hormone; D005934:Glucagon; D005947:Glucose; D006854:Hydrocortisone