Effect of high dose growth hormone with glutamine and no change in diet on intestinal absorption in short bowel patients: a randomised, double blind, crossover, placebo controlled study

被引:129
作者
Szkudlarek, J [1 ]
Jeppesen, PB [1 ]
Mortensen, PB [1 ]
机构
[1] Univ Copenhagen, Rigshosp, Dept Med, Gastroenterol Sect, DK-2100 Copenhagen, Denmark
关键词
growth hormone; glutamine; short bowel syndrome; intestinal failure; intestinal absorption; parenteral nutrition;
D O I
10.1136/gut.47.2.199
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background-High dose growth hormone, glutamine, and a high carbohydrate diet may improve intestinal function in short bowel patients. Aims-To investigate if growth hormone with glutamine and no change in diet improved intestinal function. Patients and methods-Eight short bowel patients were randomised in at double blind crossover study between placebo and growth hormone (mean 0.12 mg/kg/day) with oral (mean 28 g/day) and parenteral glutamine (mean 5.2 g/day) for 28 days. Balance studies were performed at baseline and five days after placebo and treatment were terminated. Dietary energy, carbohydrate, and fat were maintained as usual. Results-Growth hormone with glutamine did not improve intestinal absorption of energy (baseline, placebo, treatment, mean: 46%, 48%, 46% of oral intake, respectively), carbohydrate (71%, 70%, 71%), fat (20%, 15%, 18%), nitrogen (27%, 18%, 19%), wet weight (37%, 39%, 31%), sodium (-16%, -16%, -36%), potassium (43%, 47%, 33%), calcium (-16%, -16%, -15%) or magnesium (-3%, 4%, 2%) compared with placebo or baseline (p>0.05) five days after treatment was terminated. All patients experienced adverse effects. Conclusions-Combined high dose growth hormone and glutamine administered for four weeks did not improve intestinal absorption five days after treatment was terminated in short bowel patients on their usual diet.
引用
收藏
页码:199 / 205
页数:7
相关论文
共 17 条
[1]   QUANTITATION OF FECAL CARBOHYDRATE EXCRETION IN PATIENTS WITH SHORT BOWEL SYNDROME [J].
AMEEN, VZ ;
POWELL, GK ;
JONES, LA .
GASTROENTEROLOGY, 1987, 92 (02) :493-500
[2]   Does growth hormone and glutamine enhance bowel absorption? [J].
Byrne, T ;
Wilmore, D .
GASTROENTEROLOGY, 1998, 114 (05) :1110-1111
[3]   GROWTH-HORMONE, GLUTAMINE, AND A MODIFIED DIET ENHANCE NUTRIENT ABSORPTION IN PATIENTS WITH SEVERE SHORT-BOWEL SYNDROME [J].
BYRNE, TA ;
MORRISSEY, TB ;
NATTAKOM, TV ;
ZIEGLER, TR ;
WILMORE, DW .
JOURNAL OF PARENTERAL AND ENTERAL NUTRITION, 1995, 19 (04) :296-302
[4]   A NEW TREATMENT FOR PATIENTS WITH SHORT-BOWEL SYNDROME - GROWTH-HORMONE, GLUTAMINE, AND A MODIFIED DIET [J].
BYRNE, TA ;
PERSINGER, RL ;
YOUNG, LS ;
ZIEGLER, TR ;
WILMORE, DW .
ANNALS OF SURGERY, 1995, 222 (03) :243-255
[5]  
CUMMINGS JH, 1973, LANCET, V1, P344
[6]   Low-dose recombinant human growth hormone increases body weight and lean body mass in patients with short bowel syndrome [J].
Ellegard, L ;
Bosaeus, I ;
Nordgren, S ;
Bengtsson, BA .
ANNALS OF SURGERY, 1997, 225 (01) :88-96
[7]   INCREASES IN INTESTINAL GLUCOSE-ABSORPTION AND HEPATIC GLUCOSE-UPTAKE ELICITED BY LUMINAL BUT NOT VASCULAR GLUTAMINE IN THE JOINTLY PERFUSED SMALL-INTESTINE AND LIVER OF THE RAT [J].
GARDEMANN, A ;
WATANABE, Y ;
GROSSE, V ;
HESSE, S ;
JUNGERMANN, K .
BIOCHEMICAL JOURNAL, 1992, 283 :759-765
[8]   IN-VIVO AND IN-VITRO EFFECTS OF HUMAN GROWTH-HORMONE ON RAT INTESTINAL ION-TRANSPORT [J].
GUARINO, A ;
CANANI, RB ;
IAFUSCO, M ;
CASOLA, A ;
RUSSO, R ;
RUBINO, A .
PEDIATRIC RESEARCH, 1995, 37 (05) :576-580
[9]   The influence of a preserved colon on the absorption of medium chain fat in patients with small bowel resection [J].
Jeppesen, PB ;
Mortensen, PB .
GUT, 1998, 43 (04) :478-483
[10]   Intestinal failure defined by measurements of intestinal energy and wet weight absorption [J].
Jeppesen, PB ;
Mortensen, PB .
GUT, 2000, 46 (05) :701-706