Background
We recently showed that mechanisms of protein turnover in skeletal muscle are unresponsive
to amino acid (AA) infusion in severely burned pediatric patients at 6 months postinjury.
In the current study, we evaluated whether oxandrolone treatment affects mechanisms
of protein turnover in skeletal muscle and whole-body protein breakdown in pediatric
burn patients 6 months postinjury.
Methods
At the time of admission, patients were randomized to control or oxandrolone treatments.
The treatment regimens were continued until 6 months postinjury, at which time patients
(n = 26) underwent study with a stable isotope tracer infusion to measure muscle and
whole-body protein turnover.
Results
Protein kinetics in leg muscle were expressed in nmol/min per 100 mL leg volume (mean
± SE). During AA infusion, rates of protein synthesis in leg muscle were increased
(P < .05) in both groups (basal vs AA: control, 51 ± 8 vs 86 ± 21; oxandrolone, 56 ±
7 vs 96 ± 12). In the control group, there was also a simultaneous increase in breakdown
(basal vs AA: 65 ± 10 vs 89 ± 25), which resulted in no change in the net balance
of leg muscle protein (basal vs AA: −15 ± 4 vs −2 ± 10). In the oxandrolone group,
protein breakdown did not change (basal vs AA: 80 ± 12 vs 77 ± 9), leading to increased
net balance (basal vs AA: −24 ± 7 vs 19 ± 7; P < .05). Protein breakdown at the whole-body level was not different between the groups.
Conclusion
Long-term oxandrolone treatment increased net deposition of leg muscle protein during
AA infusion by attenuating protein breakdown, but did not affect whole-body protein
breakdown.
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References
- The metabolic response to burns.J Clin Invest. 1956; 35: 62-77
- Persistence of muscle catabolism after severe burn.Surgery. 2000; 128: 312-319
- Skeletal muscle is anabolically unresponsive to an amino acid infusion in pediatric burn patients 6 months postinjury.Ann Surg. 2011; 253: 592-597
- Abnormal insulin sensitivity persists up to three years in pediatric patients post-burn.J Clin Endocrinol Metab. 2009; 94: 1656-1664
- Oxandrolone: a potent anabolic steroid of novel chemical configuration.J Clin Endocrinol Metab. 1962; 22: 921-924
- Oxandrolone disposition and metabolism in man.Clin Pharmacol Ther. 1973; 14: 862-869
- The anabolic androgenic steroid oxandrolone in the treatment of wasting and catabolic disorders: review of efficacy and safety.Drugs. 2004; 64: 725-750
- Oxandrolone in AIDS-wasting myopathy.AIDS. 1996; : 101657-101662
- Favorable final height outcome in girls with Ullrich-Turner syndrome treated with low-dose growth hormone together with oxandrolone despite starting treatment after 10 years of age.J Pediatr Endocrinol Metab. 2002; 15: 129-138
- Oxandrolone therapy in constitutionally delayed growth and puberty.Pediatrics. 1995; 96: 1095-1100
- Oxandrolone, an anabolic steroid, significantly increases the rate of weight gain in the recovery phase after major burns.J Trauma. 1997; 43: 47-51
- The anticatabolic and wound healing effects of the testosterone analog oxandrolone after severe burn injury.J Crit Care. 2000; 15: 12-17
- Anabolic effects of oxandrolone after severe burn.Ann Surg. 2001; 233: 556-564
- Improved net protein balance, lean mass, and gene expression changes with oxandrolone treatment in the severely burned.Ann Surg. 2003; 237: 801-811
- Gene expression patterns in skeletal muscle of thermally injured children treated with oxandrolone.Ann Surg. 2003; 237: 422-428
- The effect of oxandrolone on the endocrinologic, inflammatory, and hypermetabolic responses during the acute phase postburn.Ann Surg. 2007; 246: 351-362
- Effects of long-term oxandrolone administration in severely burned children.Surgery. 2004; 136: 219-224
- Metabolic and hormonal changes of severely burned children receiving long-term oxandrolone treatment.Ann Surg. 2005; 242: 384-391
- The long-term effect of oxandrolone on hepatic acute phase proteins in severely burned children.J Trauma. 2004; 56: 37-44
- Burn applied research team. Effects of oxandrolone on outcome measurements in the severely burned: a multicenter prospective randomized double-blind trial.J Burn Care Res. 2006; 27: 131-139
- Isotope tracers in metabolic research.John Wiley & Sons, New York2005
- The effects of oxandrolone and exercise on muscle mass and function in children with severe burns.Pediatrics. 2007; 119: 106-119
- Androgen therapy induces muscle protein anabolism in older women.J Clin Endocrin Metab. 2006; 91: 3844-3849
- Testosterone administration in severe burns ameliorates muscle catabolism.Crit Care med. 2001; 29: 1936-1942
- Temporal cytokine profiles in severely burned patients: a comparison of adults and children.Mol Med. 2008; 14: 553-560
- Pathophysiological response to severe burn injury.Ann Surg. 2008; 248: 387-401
- Cortisol-induced suppression of plasma testosterone in normal adult males.J Clin Endocrinol Metab. 1976; 43: 622-629
- Mechanism of glucocorticoid-induced suppression of testicular androgen biosynthesis in vitro.Biol Reprod. 1982; 27: 1138-1146
- Binding of glucocorticoid antagonist to androgen and glucocorticoid hormone receptors in rat skeletal muscle.J Steroid Biochem. 1986; 24: 481-487
- Evidence for sex-dependent anabolic response to androgenic steroids mediated by muscle glucocorticoid receptors in the rat.J Steroid Biochem. 1988; 29: 575-581
Article info
Publication history
Published online: February 21, 2011
Accepted:
December 7,
2010
Footnotes
Supported by NIH grant P50 GM 60338, Shriners Mass Spectrometry Core Grant 84090, and Shriners grant 87600.
Identification
Copyright
© 2011 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
