Sanz París A, Albero Gamboa R, Orden Gonzalo I, Playán Usón J, Celaya Pérez S
Sección de Endocrinología y Nutrición, Hospital Miguel Servet, Zaragoza, España.
Nutr Hosp. 1994 Sep-Oct;9(5):295-303.
When the supply of energetic substrates is insufficient to slow the development of the catabolism, the next step is to focus on the neuro-endocrine mechanism which regulates the anabolism-catabolism balance. In this work, we review the endocrine response to stress and its implications in protein metabolism, in order to evaluate the different therapeutic possibilities available. Pharmacological blocking of the secretion of catabolic hormones (glucagon and catecholamines) has been unsuccessful up to now. Insulin is the only hormone which produces anabolism in all energetic substrates, but the results published about its administration with glucose and amino acids and its effects upon the nitrogen balance are controversial. The administration of anabolic steroids such as nandrolone, stanolone, and methenolone are usually associated with protein anabolism with minimum androgenizing action. The most recent works lead to the study of the effects of the use of GH and IGF-1 with clearly hopeful results. We have not yet acquired enough experience to use these methods in the habitual clinical practice. At the moment, the clinical studies are in the experimental stage and their application in nutrition is not accepted by the official authorities.
当高能底物的供应不足以减缓分解代谢的发展时,下一步就是关注调节合成代谢与分解代谢平衡的神经内分泌机制。在这项工作中,我们回顾了应激的内分泌反应及其在蛋白质代谢中的意义,以便评估现有的不同治疗可能性。到目前为止,对分解代谢激素(胰高血糖素和儿茶酚胺)分泌的药理学阻断尚未成功。胰岛素是唯一能在所有高能底物中产生合成代谢的激素,但关于其与葡萄糖和氨基酸一起给药及其对氮平衡影响的已发表结果存在争议。合成代谢类固醇如诺龙、司坦唑醇和美睾酮的给药通常与具有最小雄激素作用的蛋白质合成代谢相关。最新的研究成果促使人们对使用生长激素(GH)和胰岛素样生长因子-1(IGF-1)的效果进行研究,且取得了明显令人鼓舞的结果。我们尚未获得足够的经验在常规临床实践中使用这些方法。目前,临床研究正处于实验阶段,其在营养领域的应用尚未得到官方机构的认可。