title: Growth hormone level at admission and its evolution during refeeding are predictive of short-term outcome in restrictive anorexia nervosa.
abstract: The growth hormone (GH)–insulin-like growth factor-1 (IGF-1) axis is dramatically altered in patients with anorexia nervosa (AN). The aim of the present study was to investigate whether GH and IGF-1 could be predictors of outcome in patients with a restrictive form of AN. Blood levels of GH, IGF-1, adipocytokines, ghrelin, insulin, glucose, and sex and thyroid hormones were measured in eleven women inpatients with AN and in ten healthy women controls. Three stages were compared during refeeding: admission (T0), when BMI reached 16 kg/m2 (T1) and at discharge when BMI reached 17.5 kg/m2 (T2). Clinical status was assessed 6 months after discharge from hospital (T3), and remission was defined by the maintenance of a BMI > or = 17.5 kg/m2. AN patients in remission (AN-R; n 6) had significantly higher GH levels at admission than those who relapsed (AN-NR; n 5) (P < 0.05). During refeeding (delta = T2 - T0), the AN-R group differed from the AN-NR group only by both GH level decrease (P < 0.05) and BMI increase (P < 0.05). In multiple regression analysis, delta GH was associated negatively and significantly and delta leptin and delta body fat mass levels were associated positively and significantly with BMI at T3 and explained 88% of its variability (r2 0.88, P < 0.05). The present study suggests that a low GH level at admission and the absence of its decrease after weight recovery could predict short-term relapse in women suffering from a restrictive form of AN.
authors.affiliation: UMR 1062 INSERM/1260 INRA, Aix-Marseille University, Marseille, France.
authors.forename: Juan P
authors.initials: JP
authors.lastname: Nogueira
authors.forename: René
authors.initials: R
authors.lastname: Valéro
authors.forename: Marie
authors.initials: M
authors.lastname: Maraninchi
authors.forename: Anne M
authors.initials: AM
authors.lastname: Lorec
authors.forename: Catherine
authors.initials: C
authors.lastname: Samuelian-Massat
authors.forename: Audrey
authors.initials: A
authors.lastname: Bégu-Le Corroller
authors.forename: Alain
authors.initials: A
authors.lastname: Nicolay
authors.forename: Jean
authors.initials: J
authors.lastname: Gaudart
authors.forename: Henri
authors.initials: H
authors.lastname: Portugal
authors.forename: Bernard
authors.initials: B
authors.lastname: Vialettes
mesh_terms: D054392:Adipokines / Q000097:blood*; D050154:Adiposity / Q000502:physiology*; D000328:Adult; D000856:Anorexia Nervosa / Q000097:blood* / Q000628:therapy; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D019382:Human Growth Hormone / Q000097:blood*; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D007334:Insulin-Like Growth Factor I / Q000032:analysis*; D016014:Linear Models; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D012008:Recurrence; D016896:Treatment Outcome
chemical_list: D054392:Adipokines; D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I