Effect of Exogenously Administered Human Growth Hormone on Protein Metabolism after Surgery for Esophageal Cancer

Kazuya Takagi, Tsuguhiko Tashiro, Yoshiya Mashima, Hideo Yamamori, Masahiko Nishizawa, Nobuyuki Nakajima

First Department of Surgery, Chiba University School of Medicine

The effect of human growth hormone (HGH) on protein metabolism in surgically stressed patients was investigated. The subjects were 13 patients undergoing subtotal esophagectomy for an esophageal tumor who were managed with total parenteral nutrition (energy 30 Cal/kg/day, protein 2 g/kg/day). These 13 patients were divided into two groups, namely, six were given HGH 24 U/day intravenously for 5 consecutive postoperative days (HGH group) and the remaining seven were not given HGH (control group). The postoperative cumulative nitrogen balance was significantly higher in the HGH group than in the control group (p<0.01). On the 3rd postoperative day (POD), the whole body protein turnover rate, together with those of synthesis and breakdown, were greater in the HGH group than in the control, especially the increase in synthesis (p<0.01). Urinary 3-methyl histidine excretion was low after surgery in HGH group compared with the control group. The difference was significant on the 6th POD (p<0.02). The release of phenylalanine and tyrosine from the skeletal muscle of the lower extremities was significantly smaller in the HGH group than in the control, when examind by femoral arteriovenous differences in amino acid composition. No adverse effect on the liver or renal function was observed with exogenously administered HGH. It is concluded that the administration of HGH in surgically stressed patients would be beneficial for whole body protein metabolism as well as skeletal muscle economy.

Key words
postoperative state of esophageal carcinoma, human growth hormone, nitrogen balance, whole body protein turnover, arteriovenous differences in amino acids

Reprint requests
Kazuya Takagi First Department of Surgery, Chiba University School of Medicine
1-8-1 Inohana, Chuoh-ku, Chiba, 260 JAPAN

Accepted
January 13, 1993

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