Abstract
Growth hormone treatment has gained attention over the past decade as a treatment for heart failure. Human growth hormone (HGH) must be administered by injections (usually daily), so there is considerable advantage to stimulation of endogenous secretion by amino acid‐based nutritional supplementation. However, studies investigating the effect of amino acid (AA) supplementation show conflicting results. Therefore, in this study we aimed to investigate the effect of nutritional supplementation on HGH production in elderly women with heart failure. Eight elderly women with heart failure participated in this randomized cross‐over study. Plasma HGH concentration was measured before and for 4 h following ingestion of a mixture of protein, carbohydrate, and fat or an AA beverage. HGH concentration was determined with ELISA kits and AA concentrations were analyzed by Liquid Chromatography–Mass Spectrometry (LCMS). Linear mixed models was performed to analyze the effect of time, treatment, and interaction. Plasma arginine and lysine concentrations were significantly higher after consumption of the AA drink compared to the mixture of protein, carbohydrate, and fat. Nonetheless, only ingestion of the protein, carbohydrate, and fat mixture (meal replacement) increased HGH concentration. HGH concentration was increased in elderly women with heart failure following consumption of a meal replacement containing protein, carbohydrate, and fat. Consumption of a mixture of amino acids failed to increase HGH concentration despite significantly greater elevations in plasma amino acid concentrations, including arginine and lysine. The stimulatory effect of the protein/carbohydrate/fat mixture was presumably mediated by factors other than increases in free amino acid concentrations.
Highlights
Heart failure is the leading cause of death and hospitalization in Western Countries (Lombardi et al 2014; Carubelli et al 2015)
In this study we aimed to investigate the effect of nutritional supplementation with a meal replacement beverage (Ensure Active Heart Health) or an amino acid beverage containing essential amino acids plus citrulline and carnitine designed for stimulation of muscle function in heart failure (AA drink) on human growth hormone (HGH) production in elderly women with heart failure
Plasma arginine and lysine concentrations, the two amino acids thought to be the most potent stimulators of HGH release (Chromiak and Antonio 2002), were significantly higher after consumption of the AA drink compared to the meal replacement drink
Summary
Heart failure is the leading cause of death and hospitalization in Western Countries (Lombardi et al 2014; Carubelli et al 2015). Despite the introduction of new drugs and treatments for patients with heart failure over the past few years, the prevalence of heart failure continues to increase and the quality of life remains poor (Heidenreich et al 2013; Carubelli et al 2015). One treatment for heart failure patients that is gaining attention over the past decade is human growth hormone (HGH). HGH has been shown to correct abnormal vascular reactivity in chronic heart failure patients (Napoli et al 2002; Andreassen 2010). HGH is an important anabolic mediator and has therapeutic potential impact on heart failure patients, since chronic heart failure results in a catabolic state of the body and loss of physical function (Cicoira et al 2003; Hakuno et al 2015)
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