Impact of growth hormone with hypocaloric nutrition on nitrogen balance and blood glucose in patients after gastrointestinal operation

OBJECTIVE: To evaluate the impact of recombinant human growth hormone (rhGH) combined with hypocaloric nutrition on nitrogen balance and blood glucose in patients after gastrointestinal operation. METHODS: Forty-eight patients undergone abdominal operations were randomly divided into either subcutaneous rhGH (0.15 IU/kg) or placebo (menstruum) injection daily for 7 days postoperatively. These two groups had similar nutritional intakes. Body weight, blood cell count, liver and renal function, plasma albumin, prealbumin, transferrin and fibronectin were measured at day 1 before operation as baseline and day 3 and day 10 after operation by standard laboratory techniques. Nitrogen balance and blood glucose were measured from day 3 to day 9 after operation. RESULTS: At postoperative day 10, the cumulative nitrogen balance and the level of plasma fibronectin were significantly higher in rhGH group [13.21 g,(104.77+/-19.94) mg/L] than those in placebo group [-6.88 g, (93.03+/-16.03) mg/L] (P<0.05). Furthermore, at day 4 and from day 6 to day 9 after operation, daily nitrogen balance was higher in rhGH group than that in control group (P<0.05). Mean blood glucose level was significantly higher in rhGH group from day 3 to day 6 after operation [(7.68+/-2.15) vs (5.95+/-2.34) mmol/L, P<0.05]. But hyperglycemia could be controlled well by insulin treatment. CONCLUSION: Growth hormone combined with hypocaloric nutrition is effective and safe in promoting positive nitrogen balance and protein synthesis in post-operative patients, which is also beneficial to the improvement of nutritional status and prognosis.