Women and Men in the ICU: Their Growth Hormone Systems Fail Differently During Critical Illness | Research

The takeaway

Women in prolonged critical illness maintained higher GH pulse frequency and IGF-1 levels than men despite similar GH secretory mass, suggesting gender-specific GH axis resilience that may protect women from adverse ICU outcomes.

Gender gap
Female ICU patients had higher GH pulse frequency and IGF-1 despite similar total GH output — a hormonal resilience advantage

What the researchers found

Female ICU patients maintained higher GH pulse frequency and IGF-1 levels than males during protracted critical illness, with gender-modulated responses to GHRP-2/GHRH stimulation, potentially explaining women's better ICU survival.

Why it matters

Understanding why women survive ICU better could lead to gender-tailored treatment strategies, including sex-specific GH secretagogue dosing protocols.

How the study worked

Clinical trial with intensive GH profiling (10-min sampling over 24h) in prolonged critically ill men and women, with GHRP-2/GHRH stimulation testing. IGF-1 and binding proteins measured.

What this study cannot tell us

Small sample inherent to intensive ICU sampling. Gender comparison confounded by baseline sex differences in GH secretion. Mechanistic link to survival not directly established.

How to read the evidence

Strong evidence from intensive hormonal profiling in a clinically relevant population, though limited by small sample and observational gender comparison.

When this study was published

Published in 2000. Gender-specific critical care medicine is an emerging field with growing recognition of biological sex differences in disease outcomes.

The bigger picture

Gender differences in disease outcomes are increasingly recognized but poorly understood. This study provides a specific hormonal mechanism that may explain women's ICU survival advantage.

Questions still open

Should ICU GH secretagogue therapy be dosed differently by gender?
Does estrogen protect the GH axis during critical illness?
Can the female GH pattern be replicated pharmacologically in men?

Common questions

Why do women survive ICU better?

This study suggests women maintain better growth hormone pulsatility and IGF-1 during critical illness. These hormones support tissue repair and protein building, which are crucial for ICU recovery.

Should men and women be treated differently in the ICU?

This research suggests gender-specific approaches may be beneficial. Men's greater GH axis suppression during critical illness could potentially be corrected with tailored GH secretagogue therapy.

Read the original research

A paradoxical gender dissociation within the growth hormone/insulin-like growth factor I axis during protracted critical illness.

The Journal of clinical endocrinology and metabolism, 85(1), 183-92

View on PubMed ↗

Citation

Van den Berghe, G; Baxter, R C; Weekers, F; Wouters, P; Bowers, C Y; Veldhuis, J D. (2000). A paradoxical gender dissociation within the growth hormone/insulin-like growth factor I axis during protracted critical illness.. The Journal of clinical endocrinology and metabolism, 85(1), 183-92.