ALTERED LIPID KINETICS IN ADJUVANT RECOMBINANT HUMAN GROWTH HORMONE-TREATED MULTIPLE-TRAUMA PATIENTS

Adjuvant recombinant human growth hormone therapy during the postinjur y period may improve the efficiency of utilization of body energy stor es. In a group of 20 severely injured highly catabolic hypermetabolic adult multiple-trauma victims, we have investigated the basic lipid ki netics of trauma (study I) and its modification after 7 days of intrav enous feeding (total parenteral nutrition) with (group H, n = 10) or w ithout (group C, n = 10) daily rhGH (0.15 mg somatotropin.kg(-1).day(- 1)) intramuscular injections (study II). Whole body lipolysis rate (2- stage primed constant infusion of 10% glycerol), substrate net oxidati on rates (indirect calorimetry), and plasma levels of hormones were de termined. Compared with the control group (group C) the treatment grou p (group H) showed significantly (P = 0.006) enhanced rates of lipolys is and free fatty acid reesterification (10 +/- 2 to 18 +/- 2 kcal.kg( -1).day(-1), P = 0.05). As a function of resting energy expenditure (R EE), a trend of increased net glucose oxidation [32 +/- 10 vs. 56 +/- 7% REE, not significant (NS)] and decreased fat (40 +/- 8 vs. 25 +/- 5 % REE, NS) and protein oxidation rates (28 +/- 2 vs. 19 +/- 2% REE, P = 0.007) were also indicated. The simultaneous operation of increased lipolytic and reesterification processes may allow the adipocyte to re spond rapidly to changes in peripheral metabolic fuel requirements in injury.