Plasma GH and somatomedin activity (SMA) in relation to growth retardation and weight changes in anorexia nervosa (AN)

Abstract

In 3 prepubertal children with AN a severe growth retardation with low SMA was observed. This lead us to investigate the GH-SMA relationship in 13 severly underweight cases, 7 of which were aged 8-14 yr and presented low growth rates (0-3.5 cm/yr). A decreased SMA was found in 10/12 cases. By contrast GH secretion after AITT was normal in 9 cases. Plasma SMA could not be stimulated by hGH administered acutely in 2 cases (8 mg/m2/d × 4d; or during 5 months in one case (6 mg/wk). On follow-up of 6 cases, weight gain was accompanied by increased SMA values. In 2 of these, normal SMA values were observed, in spite of low GH response to AITT and in the absence of hyperinsulinism. In conclusion 1) growth retardation in AN is better correlated with SMA than GH response to AITT, 2) there is a state of resistance to endogenous and exogenous GH, 3) adequate weight gain with increased SMA may be necessary for catch-up growth in early affected children.