Effects of rhIGF-1 administration on surrogate markers of bone turnover in adolescents with anorexia nervosa

Bone. 2009 Sep;45(3):493-8. doi: 10.1016/j.bone.2009.06.002. Epub 2009 Jun 10.


Background: Adolescents with anorexia nervosa (AN) have low bone density and low levels of surrogate markers of bone formation. Low bone density is a consequence of hormonal alterations that include hypogonadism and decreases in IGF-1, a bone trophic factor. Although IGF-1 is key to pubertal bone accretion, and effects have been demonstrated in adults, there are no data regarding the effect of recombinant human (rh) IGF-1 administration in adolescents with AN.

Objectives: We hypothesized that rhIGF-1 would cause an increase in PINP, a bone formation marker, in girls with AN, without any effect on CTX, a bone resorption marker.

Subjects and methods: RhIGF-1 was administered at a dose of 30-40 mcg/k twice daily to 10 consecutive girls with AN 12-18 years old for 7-9 days. Ten age-matched girls with AN were followed without rhIGF-1 for a similar period. IGF-1, PINP and CTX levels were measured.

Results: RhIGF-1 administration caused an increase in IGF-1 from day-1 to day-4/5 (p<0.0001) and day-1 to day-8/9 (p<0.0001). Simultaneously, PINP increased from day-1 to day-4/5 (p=0.004) and day-1 to day-8/9 (p=0.004), with a smaller increase from day-4/5 to day-8/9 (p=0.048). CTX levels did not change with rhIGF-1 administration. No changes occurred in IGF-1 or PINP levels in girls not receiving rhIGF-1; however, CTX levels increased significantly (p=0.01). Percent change in PINP was significantly higher (p=0.02) and percent change in CTX was significantly lower (p=0.006) in girls who received rhIGF-1 compared to those who did not receive any intervention. RhIGF-1 was well tolerated without hypoglycemia.

Conclusion: Short-term administration of rhIGF-1 causes an increase in a surrogate bone formation markers in girls with AN without significant side effects.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Anorexia Nervosa / blood*
  • Anorexia Nervosa / drug therapy
  • Anorexia Nervosa / physiopathology
  • Biomarkers / blood
  • Bone Density / drug effects
  • Collagen Type I / blood
  • Female
  • Humans
  • Insulin-Like Growth Factor I / administration & dosage
  • Insulin-Like Growth Factor I / metabolism
  • Insulin-Like Growth Factor I / pharmacology*
  • Osteogenesis*
  • Peptide Fragments / blood
  • Peptides / blood
  • Procollagen / blood
  • Recombinant Proteins / administration & dosage
  • Recombinant Proteins / pharmacology


  • Biomarkers
  • Collagen Type I
  • Peptide Fragments
  • Peptides
  • Procollagen
  • Recombinant Proteins
  • collagen type I trimeric cross-linked peptide
  • procollagen Type I N-terminal peptide
  • Insulin-Like Growth Factor I