Belcher, H. J. C. R.; (1990) An investigation of the anabolic actions of biosynthetic human growth hormone after injury by burning. Masters thesis (M.S), UCL (University College London).

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Abstract

Previous clinical trials in normal subjects and post-operative patients have shown that biosynthetic growth hormone preparations increase nitrogen retention. It has been suggested that their administration to injured patients may be beneficial. A clinical trial is presented of twelve adult burned patients of whom six were allocated to receive biosynthetic human growth hormone (somatropin) and six to form a control group. Injury by burning is followed by increases in resting energy expenditure and urinary nitrogen excretion, accompanied by insulin resistance and glucose intolerance. There is a generalised fall in plasma protein concentrations, including the somatomedin, insulin-like growth factor-I. Somatropin administration causes no change in the rate of protein oxidation, the positivity of nitrogen balance or, either serum somatomedin or plasma protein concentrations. It causes an increase in the insulin-resistance already present in burned patients. Two further studies are presented in which somatropin is compared with a placebo in both unburned and burned rats. Injury by burning causes weight-loss, an increase in urinary nitrogen excretion, a fall in the serum albumin and somatomedin concentrations, and a reduction in the strength of healing laparotomy wounds. Somatropin administration to unburned rats causes a small rise in the serum somatomedin concentration and a transient increase in wound-strength. It causes no increase in the positivity of nitrogen balance or weight-gain. Its administration to the burned rat causes no effect on the serum somatomedin concentration, nitrogen balance, weight-gain or wound-healing. These three studies show that somatropin has no anabolic effect soon after injury by burning. I postulate that this failure reflects the changes observed after injury in somatomedin concentrations and the responsiveness of somatomedins to somatropin. I conclude that somatropin and related compounds are not suitable for use as anabolic agents soon after injury by burning.

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