Effects of recombinant growth factors on energy expenditure in maintenance hemodialysis patients.
We compared the metabolic effects of recombinant human (rh) insulin-like growth factor (IGF)-1 or a combination of rhIGF-1 + rh growth hormone (GH) on resting energy expenditure (REE) in 8 maintenance hemodialysis (MHD) patients. Seven males and 1 female (aged 41.6 +/- (SD) 12.4) with no evidence of malnutrition (BMI 21.6 +/- 2.2 kg/m2, serum albumin 45 +/- 2 g/l, serum IGF-1 359 +/- 165 microg/l) received either rhIGF-1 (80 microg/kg/day) or rhIGF-1 (80 microg/kg/day) + rhGH (50 microg/kg/day) for 3 days in a random crossover design. REE and the respiratory quotient (RQ) were measured at rest before and after the 3-day treatment. The results confirmed that MHD patients have a REE not different from normal individuals. REE was strongly correlated with lean body mass but not with fat mass. rhIGF-1 treatment did not modify REE despite doubling serum IGF-1 values, whereas a combined rhIGF1 + rhGH treatment significantly increased REE by 11% (p < 0.001). There was no change in RQ under both treatments, in response to a proportionate increase in VCO2 and VO2. These results show that energy expenditure is mainly dependent upon lean body mass in well-nourished MHD patients. The metabolic effects of rhIGF-1 and rhGH on energy expenditure may differ in response to their opposite effects on lipid oxidation and insulin regulation.
Tabakian
A
A
Department of Nephrology, Hôpital Edouard-Herriot, Lyon, France.
Juillard
L
L
Laville
M
M
Joly
M O
MO
Laville
M
M
Fouque
D
D
D000328:Adult; D015992:Body Mass Index; D002245:Carbon Dioxide / Q000378:metabolism; D004734:Energy Metabolism; D005260:Female; D006133:Growth Substances / Q000627:therapeutic use*; D019382:Human Growth Hormone / Q000627:therapeutic use; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption; D011994:Recombinant Proteins / Q000627:therapeutic use; D006435:Renal Dialysis; D012709:Serum Albumin / Q000378:metabolism
D006133:Growth Substances; D011994:Recombinant Proteins; D012709:Serum Albumin; D019382:Human Growth Hormone; D002245:Carbon Dioxide; D007334:Insulin-Like Growth Factor I