Neuroendocrine Unit, Massachusetts General Hospital, Boston, MA, USA.
Harvard Medical School, Boston, MA, USA.
Osteoporos Int. 2020 Feb;31(2):259-265. doi: 10.1007/s00198-019-05193-2. Epub 2019 Oct 28.
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.
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.
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.
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.
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.
神经性厌食症是一种以自我诱导性饥饿和低体重为特征的精神障碍，患有该病的女性其骨形成受损，骨量低，骨折风险增加。胰岛素样生长因子 1（IGF-1）和瘦素是两种与神经性厌食症女性低骨量相关的营养依赖性激素。我们假设 IGF-1 和瘦素也与神经性厌食症女性的骨强度估计值呈正相关。
在这项对 38 名女性（19 名神经性厌食症患者和 19 名体重正常的对照组）的横断面研究中，我们测量了血清 IGF-1 和瘦素，并对高分辨率外周定量 CT 图像进行了有限元分析，以测量桡骨和胫骨远端的刚度和失效负荷。
IGF-1 与神经性厌食症女性桡骨（僵硬度：R = 0.52，p = 0.02；失效负荷：R = 0.52，p = 0.02）和胫骨（僵硬度：R = 0.55，p = 0.01；失效负荷：R = 0.58，p = 0.01）的骨强度估计值呈强相关，但在体重正常的对照组中则无相关性。相比之下，瘦素与神经性厌食症组或体重正常对照组的骨强度估计值均无相关性。
IGF-1 与神经性厌食症女性的桡骨和胫骨骨强度估计值密切相关。还需要进一步的研究来评估重组人生长激素 1 的治疗是否会进一步提高该人群的骨强度并降低骨折风险。
