Ellegård L, Bosaeus I, Nordgren S, Bengtsson B A
Department of Clinical Nutrition, Sahlgrenska University Hospital, Gothenburg, Sweden.
Ann Surg. 1997 Jan;225(1):88-96. doi: 10.1097/00000658-199701000-00010.
The authors investigate the effects of low dose recombinant human growth hormone (rhGH) on body composition and absorptive capacity in patients with short bowel syndrome from Crohn's disease.
Patients with short bowel syndrome usually are malnourished because of malabsorption. The anabolic effects of high doses of rhGH have been tested in different clinical catabolic conditions, recently including patients with short bowel syndrome. The authors have investigated the effects of low-dose rhGH in short bowel syndrome in a placebo-controlled crossover clinical trial.
Ten patients were treated with daily subcutaneous doses of rhGH/placebo (0.5 international units/kg-1 per week-1 = 0.024 mg/kg-1 per day-1) for 8 weeks in a randomized, double-blind, placebo-controlled crossover clinical trial with a minimum of 12 weeks wash-out. Absorptive capacity and biochemical parameters were investigated in a metabolic ward before treatment and during first and last week of treatment. Body composition was determined by DEXA-Scan (Lunar DPX, Scanexport Medical, Helsingborg, Sweden), impedance analysis, and whole body potassium counting.
Low-dose rhGH doubled serum levels of insulin-like growth factor-1 (IGF-1) and increased body weight, lean body mass, and total body potassium by 5% (p < 0.05). Fat-free mass and total body water increased by 6% (p = 0.008). Increases in IGF-1 levels correlated with increases in fat-free mass (r = 0.77, p < 0.02). No significant changes in absorptive capacity of water, energy, or protein were detected.
Eight weeks of low-dose rhGH treatment leads to increases in body weight, lean body mass, and fat-free mass in patients with short bowel syndrome, correlated to increases in IGF-1 levels.
作者研究低剂量重组人生长激素（rhGH）对克罗恩病所致短肠综合征患者身体成分及吸收能力的影响。
短肠综合征患者通常因吸收不良而营养不良。高剂量rhGH的合成代谢作用已在不同的临床分解代谢状态下进行了测试，最近包括短肠综合征患者。作者在一项安慰剂对照的交叉临床试验中研究了低剂量rhGH对短肠综合征的影响。
在一项随机、双盲、安慰剂对照的交叉临床试验中，10名患者每日皮下注射rhGH/安慰剂（0.5国际单位/千克-1每周-1 = 0.024毫克/千克-1每天-1），为期8周，洗脱期至少12周。在代谢病房治疗前以及治疗的第一周和最后一周对吸收能力和生化参数进行研究。通过双能X线吸收法扫描（Lunar DPX，Scanexport Medical，瑞典赫尔辛堡）、阻抗分析和全身钾计数来确定身体成分。
低剂量rhGH使胰岛素样生长因子-1（IGF-1）血清水平翻倍，并使体重、瘦体重和全身钾增加了5%（p < 0.05）。去脂体重和全身水增加了6%（p = 0.008）。IGF-1水平的升高与去脂体重的增加相关（r = 0.77，p < 0.02）。未检测到水、能量或蛋白质吸收能力的显著变化。
八周的低剂量rhGH治疗可使短肠综合征患者的体重、瘦体重和去脂体重增加，且与IGF-1水平的升高相关。
