Effect of growth hormone insulin-like growth factor 1 axis on bone turnover in Egyptian adolescent girls with anorexia nervosa

Hewedi, D.H. ; Hamza, R.T. ; Sadek, H. ; Hussein, H. ; Zaki, N. ; Sallam, M.T. 


Background: Puberty is associated with marked changes in body weight and hormonal profile related to pubertal stage, such as insulin-like growth factor I (IGF-1). These changes are also associated with Anorexia Nervosa (AN) and may impact bone. Thus, our study aimed to study bone metabolism and possible etiology of osteopenia in Egyptian adolescent AN girls. Methods: Twenty adolescent girls with AN were studied in comparison to 30 healthy Bone Age (BA) - matched controls. All subjects were subjected to clinical evaluation, neuropsychiatric assessment, auxological measurements, bone age assessment, bone density and body composition assessment; and measurement of serum growth hormone (GH), IGF-1,ionizedcalcium,phosphorus,25 hydroxy vitamin D [25-(OH)D] and serum osteocalcin (OC). Results: Lean body mass and femoral neck Bone Mineral Density (BMD) were significantly reduced in AN patients compared with controls even when controlled for height. Serum GH was elevated significantly in patients (P= 0.01). Serum IGF-1 level was reduced significantly in AN (P < 0.0001). Serum ionized calcium, vitamin D and OC levels were significantly lower in patients (P = 0.04, 0.03 and 0.01 respectively). IGF-1 was strongly positively correlated with OC in patients (r = 0.877; P < 0.001). In stepwise regression analysis, IGF-1 caused 74% (r 2 = 0.74; P = 0.001) of variation in OC levels in AN. Conclusion: This study describes low bone formation in AN compared with BA-matched adolescents. Serum levels of IGF-1 are highly correlated with bone formation and thus IGF-1 measurement can be used as a marker for bone osteoblastic activity in AN. © 2013 Institute of Psychiatry, Ain Shams University.

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Keywords adolescents, anorexia nervosa, Egyptian, insulin like growth factor-1, osteopenia
Issue Date 2013
Journal Middle East Current Psychiatry 
URI http://research.asu.edu.eg/123456789/278

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