Insulin-like growth factor 1 (IGF-1), a nutritional marker in patients with eating disorders

Background and aims:Though low levels of insulin-like growth factor-1 (IGF- 1) have been repeatedly reported in patients with eating disorders, the nut ritional significance of IGF-1 has not been evaluated. The study aimed to a ssess the utility of IGF-1 for screening malnutrition and for monitoring nu trition intervention in patients with eating disorders. Methods: IGF-1 and nutritional status were evaluated in 82 patients, 59 with anorexia nervosa (AN), and 23 with bulimia nervosa (BN). Nutritional assessment included the evaluation of body mass index (BMI), body fat (FAT) and muscle mass (MM), assessed by skinfold anthropometry, serum albumin, transthyretin and retino l-binding protein, energy and protein intake. IGF-1 and nutritional paramet ers were revaluated in the early phase of refeeding (2-4 weeks) in 20 AN pa tients who entered a refeeding program. Results: Mean IGF-1z-score was -1.7 4 +/- 0.74 in AN, and - 0.74 +/- 0.91 in BN. Serum proteins were reduced in only a minority of patients. IGF-1 correlated with BMI (r = 0.64), FAT (r = 0.57), MAMC (mid-arm muscle circumference) (r = 0.58) and MM (r = 0.66) ( P < 0.001), while it did not correlate with serum proteins. In the early ph ase of nutritional repletion serum proteins and anthropometric parameters d id not vary significantly, while a prompt and marked increase (73.9%) of IG F-1 was observed. Conclusions. IGF-1 represents a biochemical marker of mal nutrition and a sensitive index of nutritional repletion in patients with e ating disorders. (C) 2001 Harcourt Publishers Ltd.