Can we increase protein synthesis by anabolic factors?

Wasting disease states can be characterized either by decreased or accelerated protein turnover, Slow protein turnover conditions include some chronic disease states characterized by low protein-energy intake, immobilization, tissue hypoxia, or moderate liver or kidney failure, Rapid protein turnover conditions include the acute hypercatabolic states and some chronic disease characterized by systemic inflammation. Anabolic hormones, such as growth hormone and androgenic steroids, act by stimulating protein turnover especially in skeletal muscle, These therapies appear to be safe and efficacious in chronic diseases states where they tend to increase and normalize a rate of protein turnover which is already depressed. In critically ill patients with a preexisting condition of accelerated protein turnover, it might therefore not be appropriate to further accelerate the rate of protein turnover by using these anabolic agents. Chronically uremic patients often exhibit a low protein turnover that may increase progressively with the decline of renal function, Thus, anabolic agents can normalize protein metabolism in stable patients without complications, but they should be used carefully in advanced renal failure especially during intercurrent infections. (C) 2001 by the National Kidney Foundation, Inc.