Smeets Ellen T H C, Schutzler Scott E, Wei Jeanne Y, Azhar Gohar, Wolfe Robert R
Department of Human Nutrition, Wageningen University, Wageningen, The Netherlands.
Department of Geriatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
Physiol Rep. 2017 Aug;5(15). doi: 10.14814/phy2.13366.
Growth hormone treatment has gained attention over the past decade as a treatment for heart failure. Human growth hormone (HGH) must be administered by injections (usually daily), so there is considerable advantage to stimulation of endogenous secretion by amino acid-based nutritional supplementation. However, studies investigating the effect of amino acid (AA) supplementation show conflicting results. Therefore, in this study we aimed to investigate the effect of nutritional supplementation on HGH production in elderly women with heart failure. Eight elderly women with heart failure participated in this randomized cross-over study. Plasma HGH concentration was measured before and for 4 h following ingestion of a mixture of protein, carbohydrate, and fat or an AA beverage. HGH concentration was determined with ELISA kits and AA concentrations were analyzed by Liquid Chromatography-Mass Spectrometry (LCMS). Linear mixed models was performed to analyze the effect of time, treatment, and interaction. Plasma arginine and lysine concentrations were significantly higher after consumption of the AA drink compared to the mixture of protein, carbohydrate, and fat. Nonetheless, only ingestion of the protein, carbohydrate, and fat mixture (meal replacement) increased HGH concentration. HGH concentration was increased in elderly women with heart failure following consumption of a meal replacement containing protein, carbohydrate, and fat. Consumption of a mixture of amino acids failed to increase HGH concentration despite significantly greater elevations in plasma amino acid concentrations, including arginine and lysine. The stimulatory effect of the protein/carbohydrate/fat mixture was presumably mediated by factors other than increases in free amino acid concentrations.
在过去十年中，生长激素治疗作为心力衰竭的一种治疗方法受到了关注。人生长激素（HGH）必须通过注射给药（通常是每日注射），因此通过基于氨基酸的营养补充来刺激内源性分泌具有相当大的优势。然而，研究氨基酸（AA）补充效果的研究结果相互矛盾。因此，在本研究中，我们旨在调查营养补充对老年心力衰竭女性HGH产生的影响。八名老年心力衰竭女性参与了这项随机交叉研究。在摄入蛋白质、碳水化合物和脂肪的混合物或AA饮料之前及之后4小时测量血浆HGH浓度。用ELISA试剂盒测定HGH浓度，并用液相色谱 - 质谱联用仪（LCMS）分析AA浓度。采用线性混合模型分析时间、治疗及相互作用的影响。与蛋白质、碳水化合物和脂肪的混合物相比，饮用AA饮料后血浆精氨酸和赖氨酸浓度显著更高。尽管如此，只有摄入蛋白质、碳水化合物和脂肪的混合物（代餐）会增加HGH浓度。老年心力衰竭女性在摄入含蛋白质、碳水化合物和脂肪的代餐后HGH浓度升高。尽管血浆氨基酸浓度（包括精氨酸和赖氨酸）显著升高，但摄入氨基酸混合物未能增加HGH浓度。蛋白质/碳水化合物/脂肪混合物的刺激作用可能是由游离氨基酸浓度增加以外的因素介导的。
