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

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 a 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.


Keywords: growth hormone; glutamine; short bowel syndrome; intestinal failure; intestinal absorption; parenteral nutrition