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The Effect of Recombinant Human Growth Hormone on Glucose and Leucine Metabolism in Cushing’s Syndrome¹

Department of Medicine, United Medical and Dental Schools of Guys and St. Thomas’s Hospitals, St. Thomas’s Hospital, London, United Kingdom

Address all correspondence and requests for reprints to: Dr. S. B. Bowes, Department of Medicine, 4th Floor North Wing, St. Thomas’s Hospital, Lambeth Palace Road, London, United Kingdom SE1 7EH.

Cushing’s syndrome is characterized by central obesity and muscle wasting. As GH is anabolic, it may be able to counteract the loss of body protein. To evaluate the potential therapeutic use of GH preoperatively, eight patients with Cushing’s syndrome received sc injections of recombinant human GH (0.07 U/kg·day) for 7 days. Whole body leucine and glucose turnover were measured after an infusion of [1-¹³C]leucine and [6,6-²H₂]glucose before (day 0) and after 2 and 7 days of GH treatment. Compared with the value on day 0, there was a significant increase on days 2 and 7 in insulin (P < 0.005 and P < 0.001), C peptide (P < 0.01 and P < 0.005), insulin-like growth factor I (P < 0.001), and glucose concentrations (P < 0.01 and P < 0.005) and a decrease in the leucine concentration (P < 0.005). There was no significant change in glucose production rate, glucose MCR, leucine production rate (a measure of protein degradation), or nonoxidative leucine disappearance rate (a measure of protein synthesis). The leucine MCR was increased after 7 days (P < 0.05), and the clearance of leucine into protein (nonoxidative leucine disappearance rate/leucine concentration) was increased (P < 0.05) after 2 and 7 days of GH treatment. This is consistent with GH stimulating the availability of amino acid transporters. GH may, therefore, have a therapeutic role in the preoperative treatment of Cushing’s syndrome.

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