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The relationship between bone turnover and body weight, serum insulin-like growth factor (IGF) I, and serum IGF-binding protein levels in patients with anorexia nervosa.
J Clin Endocrinol Metab. 2000 Jan; 85(1):200-6.JC

Abstract

Malnutrition is one of the risk factors for bone loss in patients with anorexia nervosa (AN). To clarify the effects of nutritional status on bone metabolism, we examined the relationship between serum levels of nutritional indicators [insulin-like growth factor I (IGF-I), IGF-binding protein-2 (IGFBP-2), and IGFBP-3] and markers for bone metabolism [serum osteocalcin and urinary excretion of C-terminal telopeptide of collagen type I (CrossLaps)] in 45 AN out-patients, including 8 severely malnourished patients who required hospitalization and iv hyperalimentation (IVH). Compared to healthy subjects, serum IGF-I and IGFBP-3 were lower, whereas IGFBP-2 was higher in out-patients who had a body mass index (BMI) less than 16.5 kg/m2. In these patients, urinary excretion of CrossLaps, a marker of bone resorption, was higher, whereas serum osteocalcin, a marker of bone formation, was lower than those in control subjects. All of these parameters were normal in patients whose BMI ranged from 16.5-18.5 kg/m2. Serum levels of osteocalcin correlated positively with BMI (r = 0.512; P<0.0001), IGF-I (r = 0.558; P<0.0001), and IGFBP-3 (r = 0.369; P<0.001) in AN out-patients. In the 8 severely malnourished AN patients, serum levels of IGF-I and osteocalcin significantly increased 3 and 7 days, respectively, after the start of a 5-week IVH therapy regimen and reached normal levels within 5 weeks, accompanied by still elevated urinary excretion of CrossLaps. The present study demonstrates that an improvement in nutritional status in AN patients during IVH therapy rapidly increases the serum IGF-I levels, followed by a progressive increase in osteocalcin, suggesting immediate start of bone formation. However, increased bone resorption appears to continue for at least 5 weeks.

Authors+Show Affiliations

Department of Medicine, Institute of Clinical Endocrinology, Tokyo Women's Medical University School of Medicine, Tokyo, Japan. BZI00174@niftysevere.or.jpNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

10634387

Citation

Hotta, M, et al. "The Relationship Between Bone Turnover and Body Weight, Serum Insulin-like Growth Factor (IGF) I, and Serum IGF-binding Protein Levels in Patients With Anorexia Nervosa." The Journal of Clinical Endocrinology and Metabolism, vol. 85, no. 1, 2000, pp. 200-6.
Hotta M, Fukuda I, Sato K, et al. The relationship between bone turnover and body weight, serum insulin-like growth factor (IGF) I, and serum IGF-binding protein levels in patients with anorexia nervosa. J Clin Endocrinol Metab. 2000;85(1):200-6.
Hotta, M., Fukuda, I., Sato, K., Hizuka, N., Shibasaki, T., & Takano, K. (2000). The relationship between bone turnover and body weight, serum insulin-like growth factor (IGF) I, and serum IGF-binding protein levels in patients with anorexia nervosa. The Journal of Clinical Endocrinology and Metabolism, 85(1), 200-6.
Hotta M, et al. The Relationship Between Bone Turnover and Body Weight, Serum Insulin-like Growth Factor (IGF) I, and Serum IGF-binding Protein Levels in Patients With Anorexia Nervosa. J Clin Endocrinol Metab. 2000;85(1):200-6. PubMed PMID: 10634387.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The relationship between bone turnover and body weight, serum insulin-like growth factor (IGF) I, and serum IGF-binding protein levels in patients with anorexia nervosa. AU - Hotta,M, AU - Fukuda,I, AU - Sato,K, AU - Hizuka,N, AU - Shibasaki,T, AU - Takano,K, PY - 2000/1/14/pubmed PY - 2000/1/14/medline PY - 2000/1/14/entrez SP - 200 EP - 6 JF - The Journal of clinical endocrinology and metabolism JO - J. Clin. Endocrinol. Metab. VL - 85 IS - 1 N2 - Malnutrition is one of the risk factors for bone loss in patients with anorexia nervosa (AN). To clarify the effects of nutritional status on bone metabolism, we examined the relationship between serum levels of nutritional indicators [insulin-like growth factor I (IGF-I), IGF-binding protein-2 (IGFBP-2), and IGFBP-3] and markers for bone metabolism [serum osteocalcin and urinary excretion of C-terminal telopeptide of collagen type I (CrossLaps)] in 45 AN out-patients, including 8 severely malnourished patients who required hospitalization and iv hyperalimentation (IVH). Compared to healthy subjects, serum IGF-I and IGFBP-3 were lower, whereas IGFBP-2 was higher in out-patients who had a body mass index (BMI) less than 16.5 kg/m2. In these patients, urinary excretion of CrossLaps, a marker of bone resorption, was higher, whereas serum osteocalcin, a marker of bone formation, was lower than those in control subjects. All of these parameters were normal in patients whose BMI ranged from 16.5-18.5 kg/m2. Serum levels of osteocalcin correlated positively with BMI (r = 0.512; P<0.0001), IGF-I (r = 0.558; P<0.0001), and IGFBP-3 (r = 0.369; P<0.001) in AN out-patients. In the 8 severely malnourished AN patients, serum levels of IGF-I and osteocalcin significantly increased 3 and 7 days, respectively, after the start of a 5-week IVH therapy regimen and reached normal levels within 5 weeks, accompanied by still elevated urinary excretion of CrossLaps. The present study demonstrates that an improvement in nutritional status in AN patients during IVH therapy rapidly increases the serum IGF-I levels, followed by a progressive increase in osteocalcin, suggesting immediate start of bone formation. However, increased bone resorption appears to continue for at least 5 weeks. SN - 0021-972X UR - https://www.unboundmedicine.com/medline/citation/10634387/The_relationship_between_bone_turnover_and_body_weight_serum_insulin_like_growth_factor__IGF__I_and_serum_IGF_binding_protein_levels_in_patients_with_anorexia_nervosa_ L2 - https://academic.oup.com/jcem/article-lookup/doi/10.1210/jcem.85.1.6321 DB - PRIME DP - Unbound Medicine ER -