Growth Hormone Nitrogen balance

Katta Bolic s severe negative nitrogen balance was caused by both her malnourished state and her intra-abdominal infection complicated by sepsis. The systemic and diverse responses the body makes to insults such as an acute febrile illness are termed the "acute phase response." An early event in this response is the stimulation of phagocytic activity (see Fig. 42.17). Stimulated macrophages release cytokines, which are regulatory proteins that stimulate the release of cortisol, insulin, and growth hormone. Cytokines also directly mediate the acute phase response of the liver and skeletal muscle to sepsis. 

Effect on Amino Acids and Protein Synthesis. The administration of growth hormone induces a positive nitrogen balance, which means that less nitrogen is excreted in the urine and the concentration of amino acid nitrogen in the blood is reduced. 

The lack of growth hormones results in generalized atrophy of muscle (heart, skeletal muscle) and viscera (liver, kidney, spleen), and at autopsy the most typical finding in patients with Simmonds cachexia is micro-splanchnia. In most cases of Simmonds disease, the patient becomes dramatically cachectic with a severe negative nitrogen balance. 

---