IGF-1 and recovery in anorexia nervosa: evidence from population-based and clinical cohorts

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ID: 314823
2026
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Abstract
CONTEXT: Anorexia nervosa (AN) is associated with severe metabolic and endocrine alterations, including growth hormone (GH) resistance and reduced insulin-like growth factor 1 (IGF-1). The longitudinal behavior of IGF-1 during treatment remains incompletely characterized. OBJECTIVE: To evaluate IGF-1 levels in current and weight restored AN, determine metabolic correlates, and examine longitudinal changes during clinical treatment. DESIGN: Cross-sectional analysis in a population-based cohort and longitudinal analysis in a clinical cohort. SETTING: UK Biobank (UKB) and a specialist eating disorder clinic. PARTICIPANTS: (i) UKB: 129 adult women with current AN, 2,380 weight restored AN, and 2,380 healthy controls (HC) matched for age, sex, and BMI. (ii) Clinical cohort: 189 adult women with AN assessed at baseline and 12-month follow-up. MAIN OUTCOMES MEASURES: Plasma IGF-1 levels; secondary metabolic and reproductive hormones including GH, insulin, glucose, FT3, and gonadal hormones. RESULTS: Across the UKB groups, IGF-1 levels showed a graded pattern: lowest in current AN, medium in weight restored AN, and highest in HC. In the clinical cohort, IGF-1 correlated positively with insulin, glucose, and FT3, and negatively with GH, consistent with GH resistance. IGF-1 levels increased significantly over 12 months of treatment (p = 0.003), with higher BMI at baseline predicting greater increases. Higher IGF-1 levels were associated with greater likelihood of menstrual function independent of BMI (p < 0.001). CONCLUSIONS: IGF-1 appears reduced in current AN and may only partly normalize with weight restoration. IGF-1 may reflect metabolic state and reproductive function, suggesting value as an indicator of severity and treatment response.
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Authors Cristiano Dani, Livio Tarchi, Lorenzo Bonacchi, Sara Haydar, Emanuele Cassioli, Eleonora Rossi, Alessandra Fanelli, Francesco De Logu, Romina Nassini, Nadia Micali, Valdo Ricca, Giovanni Castellini
Journal the journal of clinical endocrinology & metabolism
Year 2026
DOI
10.1210/clinem/dgag211
URL
https://doi.org/10.1210/clinem/dgag211
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