Effect of Recombinant Human Growth Hormone on Intestinal Absorption and Body Composition in Children With Short Bowel Syndrome

Journal of Parenteral and Enteral Nutrition - Tập 34 Số 5 - Trang 513-520 - 2010
Olivier Goulet1, M. Dabbas1, Cécile Talbotec1, Nathalie Kapel2, Myriam Rosilio3, Jean–Claude Souberbielle4, Odile Corriol5, C. Ricour1, V. Colomb1
1Department of Pediatric Gastroenterology, Hepatology and Nutrition, Hospital Necker-Enfants Malades, University of Paris-René Descartes, Paris, France
2Department of Biology, University Hospital Pitié-Salpétrière, Paris, France
3Laboratoires Lilly France, Saint Cloud, France
4Department of Biology, Hospital Necker-Enfants Malades, University of Paris-René Descartes, Paris, France
5Pharmacy, Hospital Necker-Enfants Malades, University of Paris-René Descartes, Paris, France

Tóm tắt

This prospective study aimed to establish the effect of recombinant human growth hormone (rhGH) on intestinal function in children with short bowel syndrome (SBS). Eight children with neonatal SBS were included. All were dependent on parenteral nutrition (PN) for >3 years (range, 3.8–11.6 years), with PN providing >50% of recommended dietary allowance for age (range, 50%–65%). The subjects received rhGH (Humatrope) 0.13 mg/kg/d subcutaneously over a 12‐week period. The follow‐up was continued over a 12‐month period after rhGH discontinuation. Clinical and biological assessments were performed at baseline, at the end of the treatment period, and 12 months after the end of treatment. No side effects related to rhGH were observed. PN requirements were decreased in all children during the course of rhGH treatment. Between baseline and the end of treatment, significant increases were observed in concentrations (mean ± standard deviation) of serum insulin‐like growth factor 1 (103.1 ± 49.9 µg/L vs 153.5 ± 82.2 µg/L; P < .01), serum insulin‐like growth factor–binding protein 3 (1.7 ± 0.6 mg/L vs 2.5 ± 0.9 mg/L; P < .001), and plasma citrulline (16.5 ± 14.8 µmol/L vs 25.2 ± 18.3 µmol/L; P < .05). A median 54% increase in enteral intake (range, 10%–244%) was observed (P < .001) and net energy balance improved significantly (P < .002). It was necessary for 6 children to be maintained on PN or restarted after discontinuation of rhGH treatment, and they remained on PN until the end of the follow‐up period. A 12‐week high‐dose rhGH treatment allowed patients to decrease PN, but only 2 patients could be definitively weaned from PN. Indications and cost‐effectiveness of rhGH treatment for SBS pediatric patients need further evaluation.

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Thông tin xuất bản

Journal of Parenteral and Enteral Nutrition

Tập 34 Số 5

513-520

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