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 ≥ 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 (Δ = 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, ΔGH was associated negatively and significantly and Δleptin and Δbody 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.