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Can the use of growth hormone reduce the postoperative fatigue syndrome?

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Convalescence after surgery is characterized by a period of fatigue
(POF). If we assume that the POF syndrome has a
multifactorial etiology, it is clear that the aim of
therapeutic measures should be to reduce the response to
surgical stress. The purpose of the present study was to
determine if administering exogenous human growth hormone
(hGH) can prevent the development or reduce the duration of
the POF. We carried out a placebo-controlled randomized
double-blind trial with 48 patientsafter elective
cholecystectomy (placebo, or control group, n =26;
hGH-treated group, n = 22). Eligibility criteria were strict
so as to introduce as few variables as possible. The results
obtained in the study show that for moderate surgical injury
(cholecystectomy in metabolically healthy subjects) the
administering of low doses of hGH (8 IU/day) minimized the POF
syndrome (Christensen score). Furthermore, a positive
nitrogen balance was achieved in the hGH-treated group during
the postoperative period from the first 24 hours onward. This
finding correlates with the significant increase in serum
levels of hGH(p < 0.05) and insulin-like growth factor 1
(IGF-1) (p < 0.001).On the other hand, anthropometric
measurements in the hGH-treated group revealed a slight but
continuous decrease in body weight and thickness of the
triceps skinfold; however, arm muscle circumference did not
significantly change during the postoperative period. These
findings are related to the effectsof the application of
exogenous growth hormone, which preserves or increases lean
body mass and reduces adipose tissue mass. The serum
transferrin level proved to be a reliable biochemical
indicator of POF.

Vara-Thorbeck R, Guerrero JA, Ruiz-Requena E, Garcia-Carriazo M

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