Altered lipid kinetics in adjuvant recombinant human growth hormone-treated multiple-trauma patients
Jeevanandam, M.; Petersen, S.R.
American Journal of Physiology 267(4 Pt 1): E560-E565
1994
ISSN/ISBN: 0002-9513 PMID: 7943305 Document Number: 428914
Adjuvant recombinant human growth hormone therapy during the postinjury period may improve the efficiency of utilization of body energy stores. In a group of 20 severely injured highly catabolic hypermetabolic adult multiple-trauma victims, we have investigated the basic lipid kinetics of trauma (study I) and its modification after 7 days of intravenous feeding (total parenteral nutrition) with (group H, n = 10) or without (group C, n = 10) daily rhGH (0.15 mg somatotropin cntdot kg-1 cntdot day-1) intramuscular injections (study II). Whole body lipolysis rate (2-stage primed constant infusion of 10% glycerol), substrate net oxidation rates (indirect calorimetry), and plasma levels of hormones were determined. Compared with the control group (group C) the treatment group (group H) showed significantly (P = 0.006) enhanced rates of lipolysis and free fatty acid reesterification (10 +- 2 to 18 +- 2 kcal cntdot kg-1 cntdot day-1, P = 0.05). As a function of resting energy expenditure (REE), a trend of increased net glucose oxidation (32 +- 10 vs. 56 +- 7% REE, not significant (NS)) and decreased fat (40 +- 8 vs. 25 +- 5% REE, NS) and protein oxidation rates (28 +- 2 vs. 19 +- 2% REE, P = 0.007) were also indicated. The simultaneous operation of increased lipolytic and reesterification processes may allow the adipocyte to respond rapidly to changes in peripheral metabolic fuel requirements in injury.