Attenuation of posttraumatic muscle catabolism and osteopenia by long-termgrowth hormone therapy

Objective To determine whether the beneficial effects of growth hormone persist throu ghout the prolonged hypermetabolic and hypercatabolic response to severe bu rn. Summary Background Data The hypermetabolic response to severe burn is associated with increased ene rgy expenditure, insulin resistance, immunodeficiency, and whole body catab olism that persists for months after injury. Growth hormone is a potent ana bolic agent and salutary modulator of posttraumatic metabolic responses. Methods Seventy-two severely burned children were enrolled in a placebo-controlled double-blind trial investigating the effects of growth hormone (0.05 mg/kg per day) on muscle accretion and bone growth. Drug or placebo treatment beg an on discharge from the intensive care unit and continued for 1 year after burn. Total body weight, height, dual-energy x-ray absorptiometry, indirec t calorimetry, and hormone values were measured at discharge, then at 6 mon ths, 9 months, and 12 months after burn. Results were compared between grou ps. Results Growth hormone subjects gained more weight than placebo subjects at the 9-m onth study point; this disparity in weight gain continued to expand through out the remainder of the study. Height also increased in the growth hormone group compared with controls at 12 months. Change in lean body mass was gr eater in those treated with growth hormone at 6, 9, and 12 months. Bone min eral content was increased at 9 and 12 months; this was associated with hig her parathormone levels. Conclusions Low-dose recombinant human growth hormone successfully abates muscle catabo lism and osteopenia induced by severe burn.