title: Menstrual cycle recovery in patients with anorexia nervosa: the importance of insulin-like growth factor 1.
abstract: BACKGROUND
  Follow-up visits of patients recovering from anorexia nervosa (AN) have shown that some patients do not resume menstrual cycles despite returning to the normal weight for their age and height.
  
  
  OBJECTIVE
  To verify whether leptin, insulin-like growth factor 1 (IGF-1) or another hormonal marker could be a good predictor of the return of menses.
  
  
  METHODS
  This prospective study included female adolescents diagnosed with AN or eating disorders not otherwise specified (EDNOS) and who were being treated in an ambulatory care unit during nutritional recovery. Body mass index and leptin, luteinizing hormone, estradiol and IGF-1 levels of these patients were evaluated. Blood samples were collected in the 1st (T1), 5th (T2), 10th (T3), 15th (T4) and 20th (T5) weeks of treatment. The hormone levels during nutritional recovery and at the time of the resumption of menses were analyzed.
  
  
  RESULTS
  The hormonal profiles improved after nutritional recovery, with IGF-1 correlating the most with the resumption of menses and nutritional recovery (p = 0.0001). At the resumption of menstruation, the patients showed IGF-1 levels >342.8 ng/ml.
  
  
  CONCLUSIONS
  IGF-1 was the best predictor of the return of menses in female adolescents with AN or EDNOS.
authors.affiliation: Pediatric Endocrinology Unit, Children's Institute, Teaching Hospital of the São Paulo University Medical School, São Paulo, Brazil.
authors.forename: Louise
authors.initials: L
authors.lastname: Cominato
authors.forename: Mariana Moraes Xavier
authors.initials: MM
authors.lastname: da Silva
authors.forename: Leandra
authors.initials: L
authors.lastname: Steinmetz
authors.forename: Vanessa
authors.initials: V
authors.lastname: Pinzon
authors.forename: Bacy
authors.initials: B
authors.lastname: Fleitlich-Bilyk
authors.forename: Durval
authors.initials: D
authors.lastname: Damiani
mesh_terms: D000293:Adolescent; D000856:Anorexia Nervosa / Q000097:blood* / Q000178:diet therapy / Q000503:physiopathology; D015992:Body Mass Index; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D020738:Leptin / Q000097:blood; D007986:Luteinizing Hormone / Q000097:blood; D008597:Menstrual Cycle; D011446:Prospective Studies
chemical_list: C583557:IGF1 protein, human; D020738:Leptin; D007334:Insulin-Like Growth Factor I; D007986:Luteinizing Hormone