SHORT-TERM EFFECT OF RECOMBINANT HUMAN GROWTH-HORMONE IN PATIENTS WITH ALCOHOLIC CIRRHOSIS

As growth hormone possesses anabolic properties that are active on pro tein metabolism, and thus of potential benefit to patients with chroni c liver disease, we determined the metabolic effects of recombinant hu man growth hormone on insulin-like growth factor-I (ICF-I) its specifi c binding proteins, and liver function. Twenty consecutive patients wi th cirrhosis were randomized to recombinant human growth hormone (Nord itropin, 4 I.U. twice daily) subcutaneously for 6 weeks (n=10) or conv entional medical treatment (n=10). The serum concentrations of insulin -like growth factor-I in the recombinant human growth hormone group in creased after 3 (p<0.01) and 6 weeks p<0.02), whereas no significant c hanges were observed in the control group. The change in insulin-like growth factor-I during the treatment period was expressed as area unde r the curve (AUC). The AUC(IGF-I) was significantly larger in the reco mbinant human growth hormone group (median AUC(IGF-I): 12.1, range: 0. 0-54.7 weeks.nmol/1) than in the control group (median AUC(IGF-I): 0.2 , range: -10.6-9.9 weeks.nmol/1) p<0.007). Insulin-like growth factor binding protein-3 concentrations increased in the recombinant human gr owth hormone treated patients as well as in controls, whereas no chang e in insulin-like growth factor binding protein-1 concentrations was f ound. No significant changes were seen in the area under the curve for biochemical liver function tests. We conclude that administration of recombinant human growth hormone induces an increase in very low level s of insulin-like growth factor-I, even in patients with cirrhosis wit h advanced disease, but the clinical benefits remain to be demonstrate d. (C) Journal of Hepatology.