c-peptide and 3-methylhistidine

To study the effects of growth hormone administration on insulin-like growth factor I concentration, nitrogen balance, and fuel utilization, and to study its safety in critically ill nonseptic patients.. Prospective, randomized, placebo-controlled trial.. Medical intensive care unit of a university hospital.. Eighteen critically ill nonseptic patients were studied for 8 days after admission.. Growth hormone (0.1 mg/kg/day) or placebo was administered as a continuous intravenous infusion on the second, third, and fourth days after admission. The study period was 8 days.. Plasma hormone concentrations were measured every 6 hrs and average daily values were calculated. The 24-hr urinary nitrogen and 3-methylhistidine excretion were measured. Indirect calorimetry was used to calculate fuel utilization. Insulin-like growth factor I concentrations increased in the treatment group from subnormal to normal values and remained increased despite discontinuation of growth hormone treatment (p = .02). Nitrogen balance differed between the groups upon admission: growth hormone group (3.9 +/- 4.1 g/day) vs. controls (13.8 +/- 5.4 g/day), but improved with growth hormone. This finding appeared independent of the imbalance between the groups. The 3-methylhistidine excretion was not different between the groups and did not change during growth hormone administration. Free fatty acids and glycerol concentrations increased during growth hormone treatment, but calculated fuel utilization did not change. During growth hormone treatment, insulin concentrations increased, due to the increased administration of insulin necessary for glycemic control. Side effects other than hyperglycemia were not observed.. Growth hormone administration in a heterogeneous group of critically ill nonseptic patients resulted in normalization of insulin-like growth factor I levels, even after cessation of growth hormone treatment. Nitrogen balance improved, but this change was transient. Hence, growth hormone affects nitrogen balance, probably partly independent of insulin-like growth factor I.

Topics: Blood Glucose; C-Peptide; Critical Illness; Double-Blind Method; Energy Metabolism; Glucagon; Growth Hormone; Humans; Insulin; Insulin-Like Growth Factor I; Lipids; Methylhistidines; Minerals; Nitrogen; Oxygen Consumption; Prospective Studies

In trauma patients a specific pattern of the hormone endocrine response to injury has been described. Conflicting data exist regarding the hormonal changes during sepsis. We studied the time course and variability of the hormonal and metabolic responses to severe sepsis in twelve medical patients.. Hormone levels were measured every 6 hours. Urinary nitrogen and 3-methylhistidine excretion were measured daily. Indirect calorimetry was used to calculate energy production rate (EPR).. None of the hormones measured showed a time course in individual patients. Growth hormone (1.69 +/- 0.17 ng/ml) and insulin (48 +/- 5 mU/L) values were within normal range. Cortisol value (474 +/- 44 nmol/L) was in the upper normal range. Insulin-like growth factor 1 level (12.5 +/- 5.7 nmol/L) was decreased. Nitrogen balance was negative and did not change during the study period. Neither oxygen consumption (VO2) (318 +/- 20 ml/min), carbon dioxide output (283 +/- 10 ml/min), EPR (2064 +/- 435 kcal/day), nor fuel utilization showed a time course. The variability during the study period compared with values on admission ranged from 20% (insulin-like growth factor 1) to 74% (growth hormone). The variability of calculated fuel utilization ranged from 35% (protein) to 180% (fat). The variability of VO2, carbon dioxide production, and EPR was for less, 8%.. A specific pattern in the endocrine and metabolic responses as observed in trauma patients does not occur in medical patients with severe sepsis. Hormones and calculated fuel utilization show large variations when compared with values on admission. VO2 and EPR vary for less. Nutritional needs in patients with sepsis, therefore, can be calculated on admission and need not be recalculated during the first week after admission.

Topics: Adult; Aged; Aged, 80 and over; C-Peptide; Energy Metabolism; Female; Glucagon; Growth Hormone; Humans; Hydrocortisone; Infections; Insulin; Insulin-Like Growth Factor I; Male; Methylhistidines; Middle Aged; Nitrogen

We report the coordinated metabolic, hormonal, and reproductive data of a female channel swimmer during the pre-swim training period, immediately post-swim, and in the post-swim untrained state. Urine and blood samples collected at these times were assayed for diurnal urinary catecholamines, urinary C-peptide and 3-methylhistidine, total blood ketone bodies, glycerol, the reproductive hormones, adrenal androgens, and thyroid hormones. Subcutaneous fat was measured by ultrasonography. All of the metabolic and hormonal data post-swim except cortisol reflected the severe physiological stress. Urinary catecholamines returned to near-normal levels by 12 hours post-swim. The metabolic changes were associated with reproductive changes, including a shortened luteal phase, absence of ovulation, and increased LH secretion relative to FSH. The swimmer maintained high levels of body fat; she did not become amenorrheic. Metabolic and reproductive hormone levels returned to normal by 2 months post-swim.

Topics: Adipose Tissue; Adult; C-Peptide; Catecholamines; Female; Glycerol; Gonadal Steroid Hormones; Hormones; Humans; Ketone Bodies; Menstrual Cycle; Methylhistidines; Physical Education and Training; Physical Endurance; Swimming; Thyroid Hormones; Ultrasonics