SERUM INSULIN-LIKE GROWTH FACTOR-I CONCENTRATIONS IN THE RECOVERY OF PATIENTS WITH ANOREXIA-NERVOSA

Anorexia nervosa (AN) can result in extreme malnutrition, and these pa tients frequently require inordinately large amounts of calories to pi n weight during refeeding therapy. Insulin-like growth factor-I (IGF-I ) is a polypeptide that mediates many of the anabolic effects of growt h hormone. Low levels of IGF-I have been associated with malnutrition and can cause poor weight gain. To clarify the potential relationship of IGF-I to weight gain, serial serum IGF-I, retinol-binding protein a nd prealbumin levels were measured at admission, 2 weeks and 4 weeks, in 14 consecutive consenting patients admitted for treatment of AN. Ba seline IGF-I levels were lower in the patients compared to age-matched controls (mean 20.8 +/- 2.5 vs 32.9 +/- 2.9 nmol/L, p<0.01). In patie nts with no weight gain, IGF-I levels were static. There was a stepwis e increment in the IGF-I values related to weight gain. Retinol-bindin g protein and prealbumin, proteins commonly used to assess nutritional status, did not demonstrate important correlations with weight gain. Further studies are required to determine whether or not initial low I GF-I levels impede weight gain in AN patients and whether treatment wi th IGF-I (possibly in combination with growth hormone) may be of benef it in this disease process.