Decreased Serum Levels of Acid-Labile Subunit in Patients with Anorexia Nervosa1

Abstract

One of the observations in malnutrition is that serum insulin-like growth factor (IGF)-I levels are decreased, and this decrease is associated with an altered profile of IGF binding proteins (IGFBPs). In human circulation, IGFs are mostly present as an approximately 150-kDa ternary protein complex consisting of IGFs, IGFBP-3, and acid-labile subunit (ALS). In the present study, to clarify the effect of nutrition on serum ALS levels, we investigated 33 patients with anorexia nervosa. Serum levels of ALS were measured by RIA. Furthermore, we measured serum IGF-I, IGF-II, IGFBP-2, and IGFBP-3 levels in the patients. From these data, we investigated which was the best predictor of body mass index (BMI) as a nutritional status marker. In the patients with anorexia nervosa, the serum ALS levels ranged from 0.7-16.9, with a mean of 10.6 +/- 0.7 mg/L, and the levels were significantly lower than those of normal subjects (13.8 +/- 0.8 mg/L, P < 0.05). Serum ALS levels positively correlated with BMI (r = 0.41, P < 0.05), and the levels increased during treatment. The serum IGFBP-2 levels in the patients were increased (871 +/- 91 microg/L), and the levels inversely correlated with BMI (r = -0.52, P < 0.01). The serum IGF-I and IGFBP-3 levels were low (152 +/- 14 microg/L and 2.56 +/- 0.12 mg/L, respectively), and the levels positively correlated with BMI (r = 0.46, P < 0.01; and r = 0.39, P < 0.05, respectively). The serum IGFBP-2, IGF-I, and IGFBP-3 levels returned toward normal ranges as BMI in the patients improved during treatment. Serum IGF-II levels did not correlate with BMI (r = 0.24, P = 0.17). Stepwise regression analysis revealed that serum IGFBP-2 was the best marker of BMI among these variables. The present study suggested that ALS was regulated by nutritional status, the same as IGF-I, IGFBP-2 and IGFBP-3; but the serum IGFBP-2 was the best predictor of BMI as nutritional status marker among the parameters in patients with anorexia nervosa.

Acid-Labile Subunit Levels and the Association with Response to Growth Hormone Treatment in Short Children Born Small for Gestational Age

“…We found that subjects with a lower weight and BMI had lower serum ALS levels. Others have also demonstrated lower ALS levels after calorie restriction and in patients with anorexia nervosa [35]. These results indicate that nutritional status plays a role in the regulation of serum ALS levels.…”

Уровень Кислотно-Лабильной Субъединицы В Крови Детей С Признаками Задержки Внутриутробного Развития На Фоне Нормосоматотропинемии

“…Низька маса тіла для даного гестаційного віку описана в дітей із мутацією ІФР-КЛС, але ми не знайшли кореляції між довжиною і масою тіла при народженні в [26,27]. Ці результати свідчать про те, що статус харчування відіграє певну роль у регуляції рівня КЛС у сироватці крові.…”

Growth Hormone Signaling in the Regulation of Acid Labile Subunit

“…Disease and catabolic state : Several studies demonstrate that ALS production is reduced during catabolic conditions Oster et al, 1995;Bereket et al, 1996;Lang et al, 1996;Frystyk et al, 1999;Fukuda et al, 1999;Moller et al, 2000;Kong et al, 2002a;Kong et al, 2002b). In humans, suffering from burn injury or cirrhosis, ALS synthesis is decreased (Frystyk et al, 1998;Moller et al, 2000).…”