Growth hormone-binding protein in patients with anorexia nervosa determined in two assay systems

To learn the mechanism of low plasma insulin-like growth factor-I (IGF-I) despite high growth hormone (GH) secretion in patients with anorexia nervosa, we assessed human serum GH-binding protein (BP) (GH-BP), which has been shown to be identical to the extracellular domain of GH receptor, and therefore might reflect peripheral GH receptor expression (i.e. there is a significant linear correlation between GH-BP and IGF-I at less than 2.0 U/ml in healthy children). The serum GH-BP level was determined by gel filtration and confirmed by immunoassay using GH receptor monoclonal antibody. Furthermore, we analyzed serum IGF-binding proteins (IGFBPs) by the affinity cross-linking method to determine the GH-IGF-I axis in this condition. Measurement of GH-BP by the two assays gave identical results, suggesting that serum GH-BP corresponds to the extracellular domain of GH receptor. The low GH-BP and high IGFBP levels in patients with anorexia nervosa shown in this study, which were normalized by an improved nutritional state, would indicate resistance to GH as well as to IGFs in this condition, in which the former is in part compensated by high GH levels while the latter is not.