Endocrine Abstracts

Anorexia nervosa (AN) is a psychiatric disorder featuring multiple endocrine abnormalities, comprising a decrease in IGF-I production and an increase in GH concentrations. This resistance to GH action may contribute to impaired haematopoiesis in AN as GH/IGF-I modulate blood cell proliferation and GH therapy exerts beneficial effects on hematocrit values in GH deficient patients. Aim of the present study is to evaluate the link between GH/IGF-I status and haematologic parametres in anorexia nervosa.

Patients and methods: We studied 10 patients (9 women, 1 man, age range 15–38 years, BMI range 11.5–16.4 kg/m²) affected by active restrictive eating disorder. Haematologic parametres including serum iron, transferrin, erythropoietin, folic acid, vitamin B12, reticolocytes were measured in all patients and correlated with baseline GH and IGF-I concentrations.

Results: As expected, IGF-I values were low (66.3±12.84% of age range) and GH concentrations increased (5.2±1.57 ng/ml, normal <4). Haemoglobin and leukocyte counts were on average low-normal (12.1±0.34 g/dl and 3.400±0.22/mm³, respectively) with 4 patients presenting frank anemia (Hb <11.0 g/dl) and 7 leukopenia (<4.100/mm³). However, erythropoiesis was not activated (normal erythropoietin and reticolocytes) and iron, folic acid or vitamin B12 stores were preserved. BMI was a significant determinant of IGF-I levels (r=0.63, P<0.005) whereas no correlation was detected between BMI and GH or between GH, IGF-I, BMI and parametres of erythropoiesis. Interestingly, leukocyte counts were significantly correlated with both BMI and IGF-I at covariance analysis (r=0.7, P<0.05).

Conclusions: No clear correlation between GH/IGF-I axis and erythropoiesis was detected in our series, suggesting that IGF-I is not a primary determinant of red blood cell hypoplasia in AN. Conversely, IGF-I was positively correlated with leukocyte counts and BMI. This is an additional, important overlap between endocrine and nonendocrine alterations in AN which warrants further investigations on a larger series of patients.