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

The effect of human growth hormone (HGH) on protein metabolism in surgically stressed patients was investigated. The subjects were 13 patients undergoing subtotal esophagectomy foran esophageal tumor who were managed with total parenteral nutrition (energy 30 Cal/kg/day, protein 2 g/kg/day). These 1...

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Published inNippon Shokaki Geka Gakkai zasshi Vol. 26; no. 5; pp. 1199 - 1203
Main Authors Tashiro, Tsuguhiko, Yamamori, Hideo, Mashima, Yoshiya, Nakajima, Nobuyuki, Takagi, Kazuya, Nishizawa, Masahiko
Format Journal Article
LanguageJapanese
Published The Japanese Society of Gastroenterological Surgery 1993
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ISSN0386-9768
1348-9372
1348-9372
DOI10.5833/jjgs.26.1199

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Abstract The effect of human growth hormone (HGH) on protein metabolism in surgically stressed patients was investigated. The subjects were 13 patients undergoing subtotal esophagectomy foran 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 thoseof 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.
AbstractList The effect of human growth hormone (HGH) on protein metabolism in surgically stressed patients was investigated. The subjects were 13 patients undergoing subtotal esophagectomy foran 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 thoseof 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.
Author Yamamori, Hideo
Takagi, Kazuya
Tashiro, Tsuguhiko
Nakajima, Nobuyuki
Mashima, Yoshiya
Nishizawa, Masahiko
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  fullname: Nakajima, Nobuyuki
  organization: First Department of Surgery, Chiba University School of Medicine
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  fullname: Takagi, Kazuya
  organization: First Department of Surgery, Chiba University School of Medicine
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  fullname: Nishizawa, Masahiko
  organization: First Department of Surgery, Chiba University School of Medicine
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References 23) 北村道彦, 西平哲郎, 平山克ほか: 食道癌術後の高ビリルビン血症の検討. 日消外会誌21: 2063-2068, 1988
12) 田代亜彦, 真島吉也, 山森秀夫ほか: 外科患者におけるwhole body protein tumover. 外科と代謝栄18: 403-409. 1984
5) 藤崎安明, 田代亜彦, 真島吉也ほか: 外科侵襲下の高カロリー輸液 (TPN) におけるエネルギー及びアミノ酸至適投与量の検討. 日外会誌93: 119-127, 1992
8) Ponting GA, Halliday D, Sim AJW et al: Postoperative positive nitrogen balance with intravenous hyponutrition and growth hormone. Lancet (i): 438-440, 1988
6) Okamura K, Okuma T, Tabira Y et al: Effect of administered human growth hormone on protein metabolism in septic rats. J Parenter Ent Nutr 13: 450-454, 1989
16) 武田雄一, 田代亜彦, 真島吉也ほか: 外科侵襲下における高濃度分岐鎖アミノ酸投与の効果. 日外会誌92: 785-793, 1991
7) Ward HC, Halliday D, Sim AJW et al: Protein and energy metabolism with biosynthetic human growth hormone after gastrointestinal surgery. Ann Surg 206: 56-61, 1987
24) 野口隆之, 一万田正彦, 宮川博司ほか: 食道癌術後黄疸の成因とIntestinal Decontaminationの有用性の検討. 日臨外医会誌53: 1064-1068, 1992
4) 田代亜彦, 真島吉也, 山森秀夫ほか: 侵襲期における高カロリー輸液のアミノ酸利用と組成について. 外科診療65: 280-288, 1991
11) Herndon DN, Wilmore DW, Mason AD et al: Abnormalities of phenylalanine and tyrosine kinetics. Arch Surg 113: 133-135, 1978
22) 辻中利政, 城戸良弘, 小川道雄ほか: 食道癌術後高ビリルビン血症の成因について, 第2報-拡大リンパ節郭清術の及ぼす影響. 日外会誌90: 1180-1185, 1989
25) 大阪喜彦, 加藤紘之, 田辺達三像か: 食道癌術後高ビリルビン血症症例の検討. 日臨外医会誌51: 2140-2145, 1990
1) Cuthbertson DP: The disturbance of metabolism produced by bony and non-bony injury with notes on certain abnormal conditions of bone. Biochem J 24: 1244-1264, 1930
13) Aulick LH, Wilmore DW: Increased peripheral amino acid release following burn injury. Surgery 85: 560-565, 1979
18) 高木一也, 田代亜彦. 真島吉也ほか: 外科侵襲下の蛋白代謝に対するヒト成長ホルモン投与の効果. 日外会誌92: 1545-1551, 1991
2) Tashiro T, Mashima Y, Yamamori H et al: Alteration of whole-body protein kinetics according to severity of surgical trauma in patients receiving total parenteral nutrition. J Parenter Ent Nutr 15: 169-172, 1991
20) Ziegler TR, Young LS, Ferrari-Baliviera E et al: Use of human growth hormone combined with nutritional support in a critically care unit. J Parenter Ent Nutr 14: 574-581, 1990
21) 辻中利政, 城戸良弘, 小川嘉誉ほか: 食道癌切除術後の高ビリルビン血症の検討. 日外会誌88: 939-945, 1987
10) Young VR, Haverberg LN, Belmazes C et al: Potential use of 3-methyl histidine excretionas an index of progressive reduction in muscle protein catabolism during starvation. Metabolism 23: 1429-1436, 1973
15) 林田和也, 真島吉也, 田代亜彦ほか: 術後高カロリー輸液の至適エネルギー投与量および糖・アミノ酸組成に関する検討. 日外会誌90: 343-354, 1989
3) 真島吉也, 田代亜彦, 山森秀夫ほか: 術前・術後の栄養管理. 臨外44: 591-596, 1989
17) 高木一也, 田代亜彦, 真島吉也ほか: 侵襲期蛋白代謝に対するヒト成長ホルモン投与の効果-ラット熱傷モデルにおける検討-. 外科と代謝栄24: 594-599, 1990
19) 高木一也, 田代亜彦, 真島吉也抵か: 熱傷ラットに対するヒト成長ホルモン投与による肝, 骨格筋及び全身蛋白代謝に及ぼす効果.外科と代謝栄26: 19-25, 1992
14) Felig P: The glucose alanine cycle. Metabolism 22: 179-207. 1973
9) Jiang ZM, He GZ, Zhang SY et al: Low dose growth hormone and hypocaloric nutrition attenuate the protein catabolic response after major operation. Ann Surg 210: 512-525, 1989
References_xml – reference: 4) 田代亜彦, 真島吉也, 山森秀夫ほか: 侵襲期における高カロリー輸液のアミノ酸利用と組成について. 外科診療65: 280-288, 1991
– reference: 14) Felig P: The glucose alanine cycle. Metabolism 22: 179-207. 1973
– reference: 3) 真島吉也, 田代亜彦, 山森秀夫ほか: 術前・術後の栄養管理. 臨外44: 591-596, 1989
– reference: 20) Ziegler TR, Young LS, Ferrari-Baliviera E et al: Use of human growth hormone combined with nutritional support in a critically care unit. J Parenter Ent Nutr 14: 574-581, 1990
– reference: 12) 田代亜彦, 真島吉也, 山森秀夫ほか: 外科患者におけるwhole body protein tumover. 外科と代謝栄18: 403-409. 1984
– reference: 7) Ward HC, Halliday D, Sim AJW et al: Protein and energy metabolism with biosynthetic human growth hormone after gastrointestinal surgery. Ann Surg 206: 56-61, 1987
– reference: 21) 辻中利政, 城戸良弘, 小川嘉誉ほか: 食道癌切除術後の高ビリルビン血症の検討. 日外会誌88: 939-945, 1987
– reference: 10) Young VR, Haverberg LN, Belmazes C et al: Potential use of 3-methyl histidine excretionas an index of progressive reduction in muscle protein catabolism during starvation. Metabolism 23: 1429-1436, 1973
– reference: 15) 林田和也, 真島吉也, 田代亜彦ほか: 術後高カロリー輸液の至適エネルギー投与量および糖・アミノ酸組成に関する検討. 日外会誌90: 343-354, 1989
– reference: 18) 高木一也, 田代亜彦. 真島吉也ほか: 外科侵襲下の蛋白代謝に対するヒト成長ホルモン投与の効果. 日外会誌92: 1545-1551, 1991
– reference: 11) Herndon DN, Wilmore DW, Mason AD et al: Abnormalities of phenylalanine and tyrosine kinetics. Arch Surg 113: 133-135, 1978
– reference: 23) 北村道彦, 西平哲郎, 平山克ほか: 食道癌術後の高ビリルビン血症の検討. 日消外会誌21: 2063-2068, 1988
– reference: 9) Jiang ZM, He GZ, Zhang SY et al: Low dose growth hormone and hypocaloric nutrition attenuate the protein catabolic response after major operation. Ann Surg 210: 512-525, 1989
– reference: 17) 高木一也, 田代亜彦, 真島吉也ほか: 侵襲期蛋白代謝に対するヒト成長ホルモン投与の効果-ラット熱傷モデルにおける検討-. 外科と代謝栄24: 594-599, 1990
– reference: 6) Okamura K, Okuma T, Tabira Y et al: Effect of administered human growth hormone on protein metabolism in septic rats. J Parenter Ent Nutr 13: 450-454, 1989
– reference: 1) Cuthbertson DP: The disturbance of metabolism produced by bony and non-bony injury with notes on certain abnormal conditions of bone. Biochem J 24: 1244-1264, 1930
– reference: 8) Ponting GA, Halliday D, Sim AJW et al: Postoperative positive nitrogen balance with intravenous hyponutrition and growth hormone. Lancet (i): 438-440, 1988
– reference: 24) 野口隆之, 一万田正彦, 宮川博司ほか: 食道癌術後黄疸の成因とIntestinal Decontaminationの有用性の検討. 日臨外医会誌53: 1064-1068, 1992
– reference: 13) Aulick LH, Wilmore DW: Increased peripheral amino acid release following burn injury. Surgery 85: 560-565, 1979
– reference: 19) 高木一也, 田代亜彦, 真島吉也抵か: 熱傷ラットに対するヒト成長ホルモン投与による肝, 骨格筋及び全身蛋白代謝に及ぼす効果.外科と代謝栄26: 19-25, 1992
– reference: 16) 武田雄一, 田代亜彦, 真島吉也ほか: 外科侵襲下における高濃度分岐鎖アミノ酸投与の効果. 日外会誌92: 785-793, 1991
– reference: 22) 辻中利政, 城戸良弘, 小川道雄ほか: 食道癌術後高ビリルビン血症の成因について, 第2報-拡大リンパ節郭清術の及ぼす影響. 日外会誌90: 1180-1185, 1989
– reference: 2) Tashiro T, Mashima Y, Yamamori H et al: Alteration of whole-body protein kinetics according to severity of surgical trauma in patients receiving total parenteral nutrition. J Parenter Ent Nutr 15: 169-172, 1991
– reference: 5) 藤崎安明, 田代亜彦, 真島吉也ほか: 外科侵襲下の高カロリー輸液 (TPN) におけるエネルギー及びアミノ酸至適投与量の検討. 日外会誌93: 119-127, 1992
– reference: 25) 大阪喜彦, 加藤紘之, 田辺達三像か: 食道癌術後高ビリルビン血症症例の検討. 日臨外医会誌51: 2140-2145, 1990
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SubjectTerms arteriovenous differences in amino acids
human growth hormone
nitrogen balance
postoperative state of esophageal carcinoma
whole body protein turnover
Title Effect of Exogenously Administered Human Growth Hormone on Protein Metabolism after Surgery for Esophageal Cancer
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