Abstract
Background. Muscle protein catabolism, reflected by a decrease in glutamine (GLN), a decrease
in muscle protein synthesis, and a negative nitrogen balance can be reduced by either
administration of GLN or growth hormone (GH). In this study, the effects of a combination
of GH and GLH were studied. Methods. Patients (n = 16) undergoing abdominal operation were given total parenteral nutrition
(TPN) containing either GLN alone or GLN together with GH (GH/GLN) during 3 postoperative
days. The amino acid concentration and protein synthesis in muscle tissue and the
nitrogen balance were measured. Results. GH/GLN reduced nitrogen losses compared with GLN alone (−5.8 ± 1.4 g nitrogen versus
−10.6 ± 1.1 g nitrogen, P <.05). GH/GLN maintained muscle GLN at preoperative levels compared with a 47.5%
± 6.3% decline in the GLN group. A similar decrease was seen in the fractional synthesis
rate of muscle protein postoperatively in both groups. Conclusions. GH has an additive effect given together with GLN on muscle amino acid metabolism,
preventing the decrease in the GLN concentration in skeletal muscle and diminishing
the loss of whole body nitrogen. However, the improvements in muscle amino acid concentrations
and nitrogen loss were not associated with differences between the groups in muscle
protein synthesis postoperatively. (Surgery 2001;129:576-86.)
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Article info
Publication history
Accepted:
October 25,
2000
Correspondence: Folke Hammarqvist, Gastrocentrum, Huddinge University Hospital, S-141 86 Stockholm, Sweden.Footnotes
*Supported by The Swedish Medical Research Council (Project 04210); the Maud and Birger Gustavsson Foundation; the County Council of Stockholm and the TRYGG-HANSA Research Fund; the Stockholm County Council, Public Health and Medical Science, Department of Research Development and Teaching, and The Clas Groschinsky Foundation.
**Surgery 2001;129:576-86.
Identification
Copyright
© 2001 Mosby, Inc. Published by Elsevier Inc. All rights reserved.