Comparison of the anabolic effects and complications of human growth hormone and the testosterone analog, oxandrolone, after severe burn injury

This study compared the anticatabolic and wound healing effects of the anab olic agents human growth hormone, HGH, and the testosterone analogue, oxand rolone, after severe burn injury. A randomized prospective study design was used. Patients were given HGH at a dose of 0.1 mg/kg/day (n = 20) or oxand rolone, 20 mg/day (n = 16), beginning between days 7-10 post-burn. Data was compared to burn patients not placed on either agent (n = 24). Patients we re monitored until they were sufficiently healed to be transferred to a reh abilitation center. The results of our study were as follows. All patients survived. Net weight loss was 8 +/- 2.1 kg in the control group compared with 4 +/- 1.8 kg with HGH and 3 +/- 1.2 kg with oxandrolone, a significant decrease. Net daily n itrogen loss was 12 +/- 3 g in nontreated compared to 3 g or less for each of the anabolic groups, a significant decrease. The metabolic rate in untre ated burns was 155 +/- 25% of predicted normal, compared to 178 +/- 28% for HGH and 156 +/- 20% for oxandrolone treated patients. The complete healing time of a standardized donor site, decreased from the control value of 14 +/- 2 days to 10 +/- 3 days for HGH and 10 +/- 2 days for oxandrolone treat ed patients, a significant improvement. Hyperglycemia (glucose over 225 mg/ dl 12.5 mM) was present in 100% of HGH patients compared to 55% for control and 50% for oxandrolone treated. We found that both anabolic agents significantly decreased weight and nitro gen loss and increased healing with nearly identical benefits. However HGH resulted in the significant complications of hyperglycemia and accentuated hypermetabolism. We noted no side effects with oxandrolone. (C) 1999 Elsevi er Science Ltd and ISBI. All rights reserved.