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Research Article Free access | 10.1172/JCI119139

Effects of recombinant human growth hormone on muscle protein turnover in malnourished hemodialysis patients.

G Garibotto, A Barreca, R Russo, A Sofia, P Araghi, A Cesarone, M Malaspina, F Fiorini, F Minuto, and A Tizianello

Department of Internal Medicine, University of Genoa, Italy.

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Department of Internal Medicine, University of Genoa, Italy.

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Department of Internal Medicine, University of Genoa, Italy.

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Department of Internal Medicine, University of Genoa, Italy.

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Department of Internal Medicine, University of Genoa, Italy.

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Department of Internal Medicine, University of Genoa, Italy.

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Department of Internal Medicine, University of Genoa, Italy.

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Department of Internal Medicine, University of Genoa, Italy.

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Department of Internal Medicine, University of Genoa, Italy.

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Department of Internal Medicine, University of Genoa, Italy.

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Published January 1, 1997 - More info

Published in Volume 99, Issue 1 on January 1, 1997
J Clin Invest. 1997;99(1):97–105. https://doi.org/10.1172/JCI119139.
© 1997 The American Society for Clinical Investigation
Published January 1, 1997 - Version history
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Abstract

To assess the effect of recombinant human growth hormone (rhGH) on muscle protein metabolism in uremic patients with malnutrition, forearm [3H]phenylalanine kinetics were evaluated in six chronically wasted (body weight 79% of ideal weight) hemodialysis (HD) patients in a self-controlled, crossover study. Forearm protein dynamics were evaluated before, after a 6-wk course of rhGH (5 mg thrice weekly) and after a 6-wk washout period. After rhGH: (a) forearm phenylalanine net balance--the difference between phenylalanine incorporation into and phenylalanine release from muscle proteins--decreased by 46% (-8+/-2 vs. -15+/-2 nmol/min x 100 ml at the baseline and -11+/-2 after washout, P < 0.02); (b) phenylalanine rate of disposal, an index of protein synthesis, increased by 25% (25+/-5 vs. 20+/-5 at the baseline and 20+/-4 after washout, P < 0.03); (c) phenylalanine rate of appearance, an index of protein degradation, was unchanged (33+/-5 vs. 35+/-5 at the baseline and 31+/-4 after washout); (d) forearm potassium release declined (0.24+/-0.13 vs. 0.60+/-0.15 microeq/min at the baseline, and 0.42+/-0.20 microeq/min after washout P < 0.03); (e) changes in the insulin-like growth factor binding protein (IGFBP)-1 levels and insulin-like growth factor-I (IGF-I)/IGFBP-3 ratios accounted for 15.1% and 47.1% of the percent variations in forearm net phenylalanine balance, respectively. Together, these two factors accounted for 62.2% of variations in forearm net phenylalanine balance during and after rhGH administration. These data indicate: (a) that rhGH administration in malnourished hemodialysis patients is followed by an increase in muscle protein synthesis and by a decrease in the negative muscle protein balance observed in the postabsorptive state; and (b) that the reduction in net protein catabolism obtained with rhGH can be accounted for by the associated changes in circulating free, but not total, IGF-I levels.

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