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IGF-1 is associated with estimated bone strength in anorexia nervosa

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Abstract

Summary

IGF-1 and leptin are two nutritionally dependent hormones associated with low bone mass in women with anorexia nervosa. Using finite element analysis, we estimated bone strength in women with anorexia nervosa and found that IGF-1 but not leptin correlated significantly with estimated bone strength in both the radius and tibia.

Purpose

Women with anorexia nervosa, a psychiatric disorder characterized by self-induced starvation and low body weight, have impaired bone formation, low bone mass, and an increased risk of fracture. IGF-1 and leptin are two nutritionally dependent hormones that have been associated with low bone mass in women with anorexia nervosa. We hypothesized that IGF-1 and leptin would also be positively associated with estimated bone strength in women with anorexia nervosa.

Methods

In this cross-sectional study of 38 women (19 with anorexia nervosa and 19 normal-weight controls), we measured serum IGF-1 and leptin and performed finite element analysis of high-resolution peripheral quantitative CT images to measure stiffness and failure load of the distal radius and tibia.

Results

IGF-1 was strongly correlated with estimated bone strength in the radius (R = 0.52, p = 0.02 for both stiffness and failure load) and tibia (R = 0.55, p = 0.01 for stiffness and R = 0.58, p = 0.01 for failure load) in the women with anorexia nervosa but not in normal-weight controls. In contrast, leptin was not associated with estimated bone strength in the group of women with anorexia nervosa or normal-weight controls.

Conclusions

IGF-1 is strongly associated with estimated bone strength in the radius and tibia in women with anorexia nervosa. Further studies are needed to assess whether treatment with recombinant human IGF-1 will further improve bone strength and reduce fracture risk in this population.

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Acknowledgements

We would like to that the nurses and bionutritionists of the MGH Clinical Research Center for their expert care.

Funding

The project described was supported by NIH grants R24 DK084970 (National Institute of Diabetes and Digestive and Kidney Diseases) and UL1 1TR002541 (Harvard Clinical and Translational Science Center, from the National Center for Advancing Translational Sciences).

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Authors and Affiliations

  1. Neuroendocrine Unit, Massachusetts General Hospital, Boston, MA, USA

    P. K. Fazeli, A. T. Faje, E. Meenaghan, S. T. Russell, M. Resulaj & A. Klibanski

  2. Harvard Medical School, Boston, MA, USA

    P. K. Fazeli, A. T. Faje, H. Lee, M. L. Bouxsein & A. Klibanski

  3. Division of Endocrinology and Metabolism, University of Pittsburgh School of Medicine, 200 Lothrop Street, BST W1061, Pittsburgh, PA, 15213, USA

    P. K. Fazeli

  4. Biostatistics Center, Massachusetts General Hospital, Boston, MA, USA

    H. Lee

  5. Maine Medical Center Research Institute, Scarborough, ME, USA

    C. J. Rosen

  6. Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Boston, MA, USA

    M. L. Bouxsein

Authors
  1. P. K. Fazeli
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  2. A. T. Faje
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  3. E. Meenaghan
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  5. M. Resulaj
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  6. H. Lee
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  8. M. L. Bouxsein
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  9. A. Klibanski
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Corresponding author

Correspondence to P. K. Fazeli.

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The study was approved by the Partners Institutional Review Board and complied with the Health Insurance Portability and Accountability Act guidelines. Written informed consent was obtained from all subjects.

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The authors declare that they have no conflict of interest.

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Fazeli, P.K., Faje, A.T., Meenaghan, E. et al. IGF-1 is associated with estimated bone strength in anorexia nervosa. Osteoporos Int 31, 259–265 (2020). https://doi.org/10.1007/s00198-019-05193-2

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  • DOI: https://doi.org/10.1007/s00198-019-05193-2

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