Document Detail

Effect of high-dose growth hormone and glutamine on body composition, urine creatinine excretion, fatty acid absorption, and essential fatty acids status in short bowel patients: a randomized, double-blind, crossover, placebo-controlled study.
MedLine Citation:
PMID:  11218239     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Positive effects of high dose growth hormone and glutamine (GH + GLN) on body composition in short bowel patients have been described. Lack of effects on intestinal absorption found in some studies has been ascribed to concomitant essential fatty acid (EFA) deficiency. This study describes changes in body weight (BW) and composition, 24-h urine creatinine excretion, intestinal fatty acid absorption (total, saturated, unsaturated and EFA), and EFA status in relation to treatment with GH + GLN in 8 short bowel patients. METHODS: A double-blind, crossover study between placebo and growth hormone (mean, 0.12 mg/kg/day) plus oral (mean, 28 g/day) and parenteral glutamine (mean, 5.2 g/day) for 28 days. Body composition was measured by dual-energy absorptiometry (DEXA) scans. Intestinal fatty acid absorption was evaluated in balance studies, and EFAs were measured in plasma phospholipids by gas liquid chromatography. RESULTS: Active treatment did not increase BW, lean body mass (LBM), fat mass (FM) and bone mass significantly compared with placebo treatment, but BW increased 1.03 kg (1.7%, P < 0.05), LBM 2.93 kg (8.7%, P < 0.001) and FM decreased 2.41 kg (10.6%, P < 0.001) in comparison with baseline. Twenty-four-hour urine creatinine excretion did not differ between study periods. No changes in intestinal absorption of fatty acids were seen, and no changes in EFAs measured in plasma phospholipids were observed. Only 1 of 8 patients, who did not receive parenteral lipids, had a Holman index above 0.2, indicative of EFA deficiency. All developed peripheral oedema. CONCLUSIONS: Combined high dose growth hormone and glutamine administered for 4 weeks, did not improve absorption of fatty acids or EFA status in short bowel patients. No changes in BW or composition were seen when comparing treatment to placebo periods. The increase in LBM measured by DEXA scan, comparing treatment and baseline periods, was not accompanied by an increase in the 24-h urinary creatinine excretion and is suspected to be associated with an accumulation in extracellular fluids.
P B Jeppesen; J Szkudlarek; C E Høy; P B Mortensen
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Scandinavian journal of gastroenterology     Volume:  36     ISSN:  0036-5521     ISO Abbreviation:  Scand. J. Gastroenterol.     Publication Date:  2001 Jan 
Date Detail:
Created Date:  2001-02-19     Completed Date:  2001-05-10     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0060105     Medline TA:  Scand J Gastroenterol     Country:  Norway    
Other Details:
Languages:  eng     Pagination:  48-54     Citation Subset:  IM    
Dept of Medicine CA, Rigshospitalet, University of Copenhagen, Denmark.
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MeSH Terms
Absorptiometry, Photon
Body Composition / drug effects
Body Weight / drug effects
Creatinine / urine
Cross-Over Studies
Double-Blind Method
Fatty Acids / metabolism
Fatty Acids, Essential / metabolism
Glutamine / administration & dosage*,  therapeutic use
Human Growth Hormone / administration & dosage*,  therapeutic use
Intestinal Absorption / drug effects
Middle Aged
Phospholipids / blood,  chemistry
Short Bowel Syndrome / drug therapy*,  physiopathology
Reg. No./Substance:
0/Fatty Acids; 0/Fatty Acids, Essential; 0/Phospholipids; 12629-01-5/Human Growth Hormone; 56-85-9/Glutamine; 60-27-5/Creatinine

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