Attenuation of posttraumatic muscle catabolism and osteopenia by long-term growth hormone therapy.
OBJECTIVE
To determine whether the beneficial effects of growth hormone persist throughout the prolonged hypermetabolic and hypercatabolic response to severe burn.


BACKGROUND
The hypermetabolic response to severe burn is associated with increased energy expenditure, insulin resistance, immunodeficiency, and whole body catabolism that persists for months after injury. Growth hormone is a potent anabolic agent and salutary modulator of posttraumatic metabolic responses.


METHODS
Seventy-two severely burned children were enrolled in a placebo-controlled double-blind trial investigating the effects of growth hormone (0.05 mg/kg per day) on muscle accretion and bone growth. Drug or placebo treatment began on discharge from the intensive care unit and continued for 1 year after burn. Total body weight, height, dual-energy x-ray absorptiometry, indirect calorimetry, and hormone values were measured at discharge, then at 6 months, 9 months, and 12 months after burn. Results were compared between groups.


RESULTS
Growth hormone subjects gained more weight than placebo subjects at the 9-month study point; this disparity in weight gain continued to expand throughout the remainder of the study. Height also increased in the growth hormone group compared with controls at 12 months. Change in lean body mass was greater in those treated with growth hormone at 6, 9, and 12 months. Bone mineral content was increased at 9 and 12 months; this was associated with higher parathormone levels.


CONCLUSIONS
Low-dose recombinant human growth hormone successfully abates muscle catabolism and osteopenia induced by severe burn.
Hart
D W
DW
Department of Surgery, University of Texas Medical Branch and Shriners Hospitals for Children, Galveston, Texas 77550, USA.
Herndon
D N
DN
Klein
G
G
Lee
S B
SB
Celis
M
M
Mohan
S
S
Chinkes
D L
DL
Wolf
S E
SE
D000293:Adolescent; D001823:Body Composition; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000188:drug therapy / Q000209:etiology*; D002056:Burns / Q000097:blood / Q000150:complications* / Q000378:metabolism; D002153:Calorimetry, Indirect; D002648:Child; D004734:Energy Metabolism; D005260:Female; D005500:Follow-Up Studies; D013006:Growth Hormone / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D009135:Muscular Diseases / Q000188:drug therapy / Q000209:etiology*; D013997:Time Factors; D015430:Weight Gain
D013006:Growth Hormone