Effect of growth hormone, glutamine, and diet on body composition in short bowel syndrome: a randomized, controlled study.
BACKGROUND
A previous controlled study of ten patients with short bowel syndrome (SBS) reported human recombinant growth hormone resulted in a significant increase in body weight and lean body mass (LBM) without clinical edema. The aim of this study was to assess the effect of growth hormone, glutamine, and diet on body composition.


METHODS
A randomized, 6-week, double-blind, placebo-controlled, crossover study was performed in eight patients. Active treatment was 21 days of growth hormone, oral glutamine, and a high-carbohydrate-low-fat (HCLF) diet. Body composition was determined by dual-energy x-ray absorptiometry (DEXA) scan. Treatments were compared by paired t test.


RESULTS
Active treatment resulted in significant increases in body weight (mean 3.02 +/- 0.7 kg, p < .05) and lean body mass, (mean 3.96 +/- 0.5 kg, p < .001). Percent body fat was significantly reduced in the actively treated group (mean -2.51% +/- 0.4, p < .001). Body weight returned to base-line within 2 weeks of discontinuing active treatment. Macronutrient and fluid absorption did not increase with active treatment.


CONCLUSIONS
Treatment with growth hormone, glutamine, and HCLF diet resulted in decreased percent body fat and increased body weight and LBM in patients with SBS, without an increase in macronutrient or fluid absorption. The positive findings are most likely a reflection of increased extracellular fluid because all eight patients developed peripheral edema on active treatment. Furthermore, the positive effect of active treatment does not appear to be sustained once discontinued.
Scolapio
J S
JS
Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, USA.
D000328:Adult; D000368:Aged; D001823:Body Composition / Q000187:drug effects*; D001835:Body Weight / Q000187:drug effects; D018592:Cross-Over Studies; D004040:Dietary Carbohydrates / Q000008:administration & dosage*; D004041:Dietary Fats / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D005973:Glutamine / Q000627:therapeutic use*; D013006:Growth Hormone / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012778:Short Bowel Syndrome / Q000188:drug therapy* / Q000378:metabolism
D004040:Dietary Carbohydrates; D004041:Dietary Fats; D005973:Glutamine; D013006:Growth Hormone