Use of Growth Hormone in Surgery

  • James McK. Manson
  • Douglas W. Wilmore
Part of the Serono Symposia, USA book series (SERONOSYMP)


An organism’s reaction to injury, including surgery, or infection involves not merely a local healing process, but also a systemic metabolic response. One feature of the adaptation seen is the mobilization of amino acids from muscle and their transport to visceral tissue, primarily liver, to take part in biochemical processes including the synthesis of acute phase proteins and formation of new glucose molecules. The nitrogen released from the amino acids forms urea and appears in the urine. Nitrogen loss is a consistent feature of the metabolic response to stress states, and the amount lost is generally proportional to the severity of the insult.


Growth Hormone Human Growth Hormone Nitrogen Balance Growth Hormone Treatment Growth Hormone Therapy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Holter AR, Rosen HM, Fischer JE. The effects of hyperalimentation on major surgery in patients with malignant disease: a prospective study. Acta Chir Scand 1977; 466 (suppl): 86–7.Google Scholar
  2. 2.
    Cerra FB, Siegel JH, Coleman B, et al. Septic autocannibalism. A failure of exogenous nutritional support. Ann Surg 1980; 192: 570–80.PubMedCrossRefGoogle Scholar
  3. 3.
    Brooks DC, Bessey PQ, Black PR, Aoki TT, Wilmore DW. Posttraumatic insulin resistance in uninjured forearm tissue. J Surg Res 1984; 37: 100–7.PubMedCrossRefGoogle Scholar
  4. 4.
    Hinton P, Allison SP, Littlejohn S, Lloyd J. Insulin and glucose to reduce catabolic response to injury in burned patients. Lancet 1971; i:767–9.CrossRefGoogle Scholar
  5. 5.
    Woolfson AMJ, Heatley RV, Allison SP. Insulin to inhibit protein catabolism after injury. N Engl J Med 1979; 300: 14–7.PubMedCrossRefGoogle Scholar
  6. 6.
    Tweedle D, Walton C, Johnson IDA. The effect of an anabolic steroid on post-operative nitrogen balance. Br J Clin Pract 1973; 27: 130–2.PubMedGoogle Scholar
  7. 7.
    Michelsen CB, Askanasi J, Kinney JM, et al. Effect of an anabolic steroid on nitrogen balance and amino acid patterns after total hip replacement. J Trauma 1982; 22: 410–3.PubMedCrossRefGoogle Scholar
  8. 8.
    Kostyo JL. In vitro effects of growth hormone and corticotropin on amino acid transport in muscle. Acta Endocrinol [suppl] (Copenh) 1960; 51: 943.Google Scholar
  9. 9.
    Crispell KR, Parson W, Hollifield G. The effect of growth hormone on the amino acid pool and protein synthesis rate in a pituitary dwarf. J Clin Invest 1954; 33: 924–5.CrossRefGoogle Scholar
  10. 10.
    Collipp PJ, Curti V, Thomas J, et al. Body composition changes in children receiving human growth hormone. Metabolism 1973; 22: 589.PubMedCrossRefGoogle Scholar
  11. 11.
    Korenchevsky V. The influence of the hypophysis on metabolism, growth and sexual organs of male rats and rabbits. Biochem J 1930; 24: 383–93.PubMedGoogle Scholar
  12. 12.
    Salmon WD Jr, Daughaday WH. A hormonally controlled serum factor which stimulates sulphate incorporation by cartilage in vitro. J Lab Clin Med 1957; 49: 825–35.PubMedGoogle Scholar
  13. 13.
    Anselmino KJ, Herold L, Hoffmann FR. Uber die pankreatrope witkung von hypophysenvorderlappenextrakten. Klin Wirch 1933; 12. 2: 1245–7.CrossRefGoogle Scholar
  14. 14.
    Raben MS, Hollenberg CH. Effect of growth hormone on plasma free fatty acids. J Clin Invest 1959; 38: 484–8.PubMedCrossRefGoogle Scholar
  15. 15.
    Gaebler OH. Some effects of anterior pituitary extracts on nitrogen metabolism, water balance and energy metabolism. J Exp Med 1933; 57: 349–63.PubMedCrossRefGoogle Scholar
  16. 16.
    Manson J McK, Wilmore DW. Positive nitrogen balance with human growth hormone and hypocaloric intravenous feeding. Surgery 1986; 100: 188–97.PubMedGoogle Scholar
  17. 17.
    Greenbaum AL, McLean P. The influence of pituitary growth hormone on the catabolism of fat. Biochem J 1953; 54: 413–24.PubMedGoogle Scholar
  18. 18.
    Shipley RA, Long CNH. Studies on the ketogenic activity of the anterior pituitary. J Biochem (Tokyo) 1938; 22: 2242–56.Google Scholar
  19. 19.
    Greenbaum AL. Changes in body composition and respiratory quotient of adult female rats treated with purified growth hormone. Biochem J 1953; 54: 400–7.PubMedGoogle Scholar
  20. 20.
    Carey LC, Cloutier CT, Lowery BD. Growth hormone and adrenocortical response to shock and trauma in the human. Ann Surg 1971; 174: 451–60.PubMedCrossRefGoogle Scholar
  21. 21.
    Wilmore DW, Orcutt TW, Mason AD, Pruitt BA Jr. Alterations in hypothalamic function following thermal injury. J Trauma 1975; 15: 697–703.PubMedCrossRefGoogle Scholar
  22. 22.
    Wright PD, Johnson IDA. The effect of surgical operation on growth hormone levels in plasma. Surgery 1975; 77: 479–86.PubMedGoogle Scholar
  23. 23.
    Aarima M, Syvalahti E, Viikari J, Ovaska J. Insulin, growth hormone and catecholamines as regulators of energy metabolism in the course of surgery. Acta Chir Scand 1978; 144: 411–22.Google Scholar
  24. 24.
    Beisel WR, Woeber KA, Bartelloni PJ, Ingbar SH. Growth hormone response during sandfly fever. J Clin Endocrinol Metab 1968; 28: 1220–1.PubMedCrossRefGoogle Scholar
  25. 25.
    Frohman LA, Horton ES, Lebowitz HE. Growth hormone releasing action of a Pseudomonas endotoxin. Metabolism 1967; 16: 57–67.PubMedCrossRefGoogle Scholar
  26. 26.
    Dahn MS, Mitchell RA, Smith S, et al. Altered immunologic function and nitrogen metabolism associated with depression of plasma growth hormone. JPEN 1984; 8: 690–4.CrossRefGoogle Scholar
  27. 27.
    Coates CL, Burwell RJ, Carlin SA, et al. The somatomedin activity in plasma from patients with multiple mechanical injuries: with observations on plasma Cortisol. Injury 1981; 13: 100–7.PubMedCrossRefGoogle Scholar
  28. 28.
    Frayn KN, Price DA, Maycock PF, Carroll SM. Plasma somatomedin activity after injury in man and its relationship to other hormonal and metabolic changes. Clin Endocrinol (Oxf) 1984; 20: 179–87.CrossRefGoogle Scholar
  29. 29.
    Bazzare TL, et al. Human growth changes with age. Proceedings of the third international symposium on growth hormone and related peptides. Milan, 1975. Amsterdam: Exerpta Medica, 1976.Google Scholar
  30. 30.
    Finkelstein JW, Roffwarg HP, Boyar RM, et al. Age-related change in the 24 hour spontaneous secretion of growth hormone. J Clin Endocrinol Metab 1972; 35: 665.PubMedCrossRefGoogle Scholar
  31. 31.
    Johanson AJ, Blizzard RM. Low somatomedin-C levels in older men rise in response to growth hormone administration. Johns Hopkins Med J 1981; 149: 115–7.PubMedGoogle Scholar
  32. 32.
    Cuthbertson DP, Shaw GB, Young FG. The influence of anterior pituitary extract on the metabolic response of the rat to injury. J Endocrinol 1941; 2: 468–74.CrossRefGoogle Scholar
  33. 33.
    Prudden JF, Pearson E, Soroff HS. Studies on growth hormone. II: The effect on the nitrogen metabolism of severely burned patients. Surg Gynecol Obstet 1956; 102: 695–701.PubMedGoogle Scholar
  34. 34.
    Soroff HS, Rozin RR, Mooty JM, et al. Role of human growth hormone in the response to trauma. Is Metabolic effects following burns. Ann Surg 1967; 166: 739–52.PubMedCrossRefGoogle Scholar
  35. 35.
    Liljedahl S-O, Gemzell C-A, Plantin L-O, Birke G. Effect of human growth hormone in patients with severe burns. Acta Chir Scand 1961; 122: 1–14.PubMedGoogle Scholar
  36. 36.
    Wilmore DW, Moylan JA, Bristow BF, Mason AD, Pruitt BA Jr. Anabolic effects of human growth hormone and high caloric feedings following thermal injury. Surg Gynecol Obstet 1974; 138: 875–84.PubMedGoogle Scholar
  37. 37.
    Ward HC, Halliday D, Sim AJW. Protein and energy metabolism with biosynthetic human growth hormone after gastro-intestinal surgery. Presented at ESPEN meeting, Milan 1984 (unpublished data).Google Scholar
  38. 38.
    Young LS, Ziegler TR, Manson J McK, Wilmore DW. The effects of growth hormone in patients receiving nutrition support. JPEN (in press).Google Scholar
  39. 39.
    Prudden JF, Nishihara G, Ocampo L. Studies on growth hormone. Ill: The effect on wound tensile strength of marked post-operative anabolism induced with growth hormone. Surg Gynecol Obstet 1958; 107: 481–2.PubMedGoogle Scholar
  40. 40.
    Barbul A, Rettura G, Prior E, Levenson SM, Seifter E. Supplemental arginine, wound healing and thymus: arginine-pituitary interaction. Surg Forum 1978; 29: 93.PubMedGoogle Scholar
  41. 41.
    Felig P, Marliss EB, Cahill GF Jr. Metabolic response to growth hormone during prolonged starvation. J Clin Invest 1971; 50: 411–21.PubMedCrossRefGoogle Scholar

Copyright information

© Plenum Press, New York 1988

Authors and Affiliations

  • James McK. Manson
    • 1
  • Douglas W. Wilmore
    • 1
  1. 1.Brigham and Women’s HospitalHarvard Medical School BostonUSA

Personalised recommendations