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Clinical Trial
. 2001 Jun;233(6):827-34.
doi: 10.1097/00000658-200106000-00013.

Attenuation of posttraumatic muscle catabolism and osteopenia by long-term growth hormone therapy

D W Hart  1 , D N Herndon, G Klein, S B Lee, M Celis, S Mohan, D L Chinkes, S E Wolf
Affiliations
Clinical Trial

Attenuation of posttraumatic muscle catabolism and osteopenia by long-term growth hormone therapy

D W Hart et al. Ann Surg. 2001 Jun.

Abstract

Objective: To determine whether the beneficial effects of growth hormone persist throughout the prolonged hypermetabolic and hypercatabolic response to severe burn.

Summary background data: 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.

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Figures

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Figure 1. Study procedures during the year after burn. REE, resting energy expenditure; DEXA, dual-energy x-ray absorptiometry.
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Figure 2. Lean body mass changes measured by serial dual-energy x-ray absorptiometry (DEXA) scans in the same children.
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Figure 3. Bone mineral content changes in serial dual-energy x-ray absorptiometry (DEXA) scans from the same children.
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Figure 4. Resting energy expenditure as a percentage of the predicted basal metabolic rate (BMR) over time in burned children treated with growth hormone or placebo.
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Figure 5. Scatter plot of parahormone levels with and without growth hormone (GH) treatment in severely burned children.
See this image and copyright information in PMC

References

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    1. Hart DW, Wolf SE, Mlcak R, et al. Persistence of muscle catabolism after severe burn. Surgery 2000; 128: 312–319. - PubMed
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