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Absorption of human growth hormone injected subcutaneously and intramuscularly in growth deficient dwarfs

Hunan growth hormone (HGH) is commonly administrated by i.m. injections. The high purity of the present HGH preparations makes s.c. administration an attractive alternative enabling self-administration. In this study time courses of plasma HGH after s.c and i.m.injections of highly purified HGH (NanormonR) are described and compared to the diurnal plasma HGH profile in eight normal children (11-14 years). Seven patients suffering from idiopathic HGH-deficient dwarfism (age 10-19 years) received i.m. and s.c. injection of HGH in the morning (4IU/m2) in random order with an interval of one week. I.m. injections lead to a peak HGH concentration at 2 hours (mean 204,range 135-475 ng/ml) with a return to baseline 8-10 hours after injection. Correspondingly HGH concentration peaked at 4 hrs (mean 38, range 15-68 ng/ml)after s.c. injection and returned to baseline about 18 hours after injection. In a subsequent study on similar patients (n=7,age 10-19 years) HGH (2IU/m2) was injected s.c. in the evening.HGH concentration peaked at 5 hours (mean 17,range 7-28 ng/ml) and returned to baseline 14 hours after injection.The results indicate that absorption from an i.m. depot is far too short to give a physiological diurnal profile of HGH in plasma - even by daily administration. However, daily s.c. injection will, if given in the evening, imitate normal nocturnal HGH profile.