title: Growth hormone for intestinal adaptation in patients with short bowel syndrome: systematic review and meta-analysis of randomized controlled trials.
abstract: OBJECTIVE
  The purpose of this systematic review was to assess the efficacy of growth hormone (GH) treatment in patients with short bowel syndrome (SBS).
  
  
  METHODS
  Electronic searches were performed to identify all publications describing randomized controlled trials (RCTs) on the use of GH with or without glutamine for the treatment of patients with SBS. The outcomes of interest were body weight, lean body mass, and intestinal absorption function.
  
  
  RESULTS
  Four trials involving 70 patients were included in the review. A meta-analysis of these trials suggested that GH had a positive effect in terms of increased weight (mean difference [MD] = 1.66; 95% CI, 0.69-2.63, P < 0.001), lean body mass (MD = 1.93; 95% CI, 0.97-2.90; P < 0.001), energy absorption (MD = 4.42; 95% CI, 0.26-8.58; P = 0.04), nitrogen absorption (MD = 4.85; 95% CI, 0.20-9.49; P = 0.04), and fat absorption (MD = 5.02; 95% CI, 0.21-9.82; P = 0.04) for patients with SBS. Adverse effects occurred during active treatment in all trials. Only 1 trial included a 12-week follow-up study.
  
  
  CONCLUSIONS
  The results suggest a possible short-term benefit in terms of body weight, lean body mass, and absorptive capacities; however, no conclusion of long-term efficacy of GH could be obtained. Large-scale, long-term follow-up RCTs are needed to confirm the efficacy and tolerability of GH in the future.
authors.affiliation: Nanjing University School of Medicine, Research Institute of General Surgery, Jinling Hospital, Nanjing, China.
authors.forename: Ming-Xiao
authors.initials: MX
authors.lastname: Guo
authors.affiliation: Nanjing University School of Medicine, Research Institute of General Surgery, Jinling Hospital, Nanjing, China.
authors.forename: You-Sheng
authors.initials: YS
authors.lastname: Li
authors.affiliation: Nanjing University School of Medicine, Research Institute of General Surgery, Jinling Hospital, Nanjing, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Fan
authors.affiliation: Nanjing University School of Medicine, Research Institute of General Surgery, Jinling Hospital, Nanjing, China.
authors.forename: Jie-Shou
authors.initials: JS
authors.lastname: Li
keywords: growth hormone; meta-analysis; randomized controlled trial; short bowel syndrome; systematic review