RESUMEN
Women in whom anorexia nervosa develops during adolescence have failure of linear growth associated with low levels of insulin-like growth factor I (IGF-1). To investigate the pathophysiology of growth retardation in adolescents with anorexia nervosa, we measured basal growth hormone (GH), growth hormone-binding protein (GHBP), IGF-1, and insulin-like growth factor binding protein-3 (IGFBP-3) in three groups of patients: (1) 28 recently hospitalized female adolescents with anorexia nervosa, (2) 23 of the same patients after partial weight restoration, and (3) 28 healthy control subjects matched for age, sex, and pubertal stage. Fasting GH levels in group 1 did not differ significantly from those in group 3. In contrast, serum GHBP (p < 0.001), IGF-1 (p < 0.001), and IGFBP-3 (p < 0.01) were significantly lower in group 1 than in group 3. Serum GHBP and IGFBP-3 levels were positively correlated with body mass index. Serum GHBP levels were low in patients in all five pubertal stages and even in those shown to have adequate GH secretion. In group 2 (after refeeding) the serum IGF-1 concentration increased significantly and GHBP and IGFBP-3 returned to normal. We conclude that patients with anorexia nervosa have diminished GH action resulting in decreased secretion of IGF-1. The positive correlation with body mass index and the reversibility with refeeding suggest that these changes are secondary to malnutrition. Altered GH function that occurs during the years of active growth can explain the growth retardation seen in anorexia nervosa.
Asunto(s)
Anorexia Nerviosa/fisiopatología , Hormona del Crecimiento/metabolismo , Somatomedinas/análisis , Adolescente , Adulto , Anorexia Nerviosa/tratamiento farmacológico , Anorexia Nerviosa/metabolismo , Metabolismo Basal , Índice de Masa Corporal , Proteínas Portadoras/sangre , Estudios de Casos y Controles , Niño , Femenino , Hormona del Crecimiento/sangre , Inhibidores de Crecimiento/sangre , Humanos , Proteínas de Unión a Factor de Crecimiento Similar a la Insulina , Factor I del Crecimiento Similar a la Insulina/análisisRESUMEN
We compared the frequency of ovarian microcysts in girls with premature thelarche (n = 27) to that in age-matched control subjects (n = 24). There was an increased prevalence of detectable ovarian microcysts in girls with premature thelarche. The presence or absence of cysts did not correlate with basal gonadotropin or estradiol levels.