Evidence map›Paper›PMID 33693703›Full record

Trial reportThe Journal of clinical endocrinology and metabolism2021

Effect of Transdermal Estradiol and Insulin-like Growth Factor-1 on Bone Endpoints of Young Women With Anorexia Nervosa.

Vibha Singhal, Amita Bose, Meghan Slattery, Melanie S Haines, Mark A Goldstein, Nupur Gupta, Kathryn S Brigham, Seda Ebrahimi, Kristin N Javaras, Mary L Bouxsein and 5 more

Open access · bronzeAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in The Journal of clinical endocrinology and metabolism, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed, 2 pooled it
2.5field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

14 citing papers in PubMed, 2 syntheses or guidelines pooled it, 25 citations in OpenAlex.

  1. Guideline
  2. Pooled it
  3. Trial
  4. Article
  5. Review
  6. Utilising genomic association data for causal inference in anorexia nervosa.Mammalian genome : official journal of the International Mammalian Genome Society · 2025
    Review
  7. Review
  8. Estrogen exposure and skeletal health: Special populations and considerations.Journal of the Pediatric Orthopaedic Society of North America · 2024
    Article
  9. Article
  10. Endocrine complications of anorexia nervosa.Journal of eating disorders · 2023
    Review
  11. Article
  12. The female athlete triad: review of current literature.Current opinion in endocrinology, diabetes, and obesity · 2022
    Review
  13. Review
  14. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 1 institution in 1 country.

Vibha SinghalNeuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.ORCID 0000-0002-9729-4433
Amita BoseNeuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
Meghan SlatteryNeuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
Melanie S HainesNeuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
Mark A GoldsteinDivision of Adolescent Medicine, Massachusetts General Hospital for Children and Harvard Medical School, Boston, MA, USA.
Nupur GuptaDivision of Adolescent Medicine, Massachusetts General Hospital for Children and Harvard Medical School, Boston, MA, USA.
Kathryn S BrighamDivision of Adolescent Medicine, Massachusetts General Hospital for Children and Harvard Medical School, Boston, MA, USA.
Seda EbrahimiCambridge Eating Disorders Center, Cambridge, MA, USA.
Kristin N JavarasDepartment of Psychiatry, Harvard Medical School, Boston, MA, USA.
Mary L BouxseinDivision of Endocrinology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
Kamryn T EddyEating Disorders Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
Karen K MillerNeuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
David SchoenfeldBiostatistics Center at Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
Anne KlibanskiNeuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
Madhusmita MisraNeuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
Harvard University · US

Funding

ROLE OF DIETARY CONSTITUENTS ON GENE EXPRESSION IN INTESTINAL EPITHELIUMP30DK040561 · NIDDK · MASSACHUSETTS GENERAL HOSPITAL · PI Takara Leah Stanley · 1994 to 2026
$31.6M
Effects of Anorexia Nervosa on Peak Bone MassR01DK062249 · NIDDK · MASSACHUSETTS GENERAL HOSPITAL · PI KLIBANSKI, ANNE · 2003 to 2015
$7.2M
Growth Hormone and Cardiovascular DiseaseK24HL092902 · NHLBI · MASSACHUSETTS GENERAL HOSPITAL · PI MILLER, KAREN K · 2010 to 2019
$1.6M
RESEARCH TRAINING IN MENTAL RETARDATIONT32HD007184 · NICHD · UNIVERSITY OF NOTRE DAME · PI BORKOWSKI, JOHN G · 1985 to 2010
$1.4M
Relative Sarcopenia and Cardiometabolic Risk in Young Adults with ObesityK23DK115903 · NIDDK · MASSACHUSETTS GENERAL HOSPITAL · PI HAINES, MELANIE SCHORR · 2017 to 2021
$1.1M
NHLBI NIH HHS K24 HL092902NICHD NIH HHS T32 HD007184NIDDK NIH HHS K23 DK115903NIDDK NIH HHS P30 DK040561NIDDK NIH HHS R01 DK062249
6 · The paper itself

Abstract

contextAnorexia nervosa (AN) is prevalent in adolescent girls and is associated with bone impairment driven by hormonal alterations in nutritional deficiency.

objectiveTo assess the impact of estrogen replacement with and without recombinant human insulin-like growth factor-1 (rhIGF-1) administration on bone outcomes.

designDouble-blind, randomized, placebo-controlled 12-month longitudinal study.

participantsSeventy-five adolescent and young adult women with AN age 14 to 22 years. Thirty-three participants completed the study.

interventionTransdermal 17-beta estradiol 0.1 mg/day with (i) 30 mcg/kg/dose of rhIGF-1 administered subcutaneously twice daily (AN-IGF-1+) or (ii) placebo (AN-IGF-1-). The dose of rhIGF-1 was adjusted to maintain levels in the upper half of the normal pubertal range.

main outcome measuresBone turnover markers and bone density, geometry, microarchitecture, and strength estimates.

resultsOver 12 months, lumbar areal bone mineral density increased in AN-IGF-1- compared to AN-IGF-1+ (P = 0.004). AN-IGF-1+ demonstrated no improvement in areal BMD in the setting of variable compliance to estrogen treatment. Groups did not differ for 12-month changes in bone geometry, microarchitecture, volumetric bone mineral density (vBMD), or strength (and results did not change after controlling for weight changes over 12 months). Both groups had increases in radial cortical area and vBMD, and tibia cortical vBMD over 12 months. Levels of a bone resorption marker decreased in AN-IGF-1- (P = 0.042), while parathyroid hormone increased in AN-IGF-1+ (P = 0.019). AN-IGF-1- experienced irregular menses more frequently than did AN-IGF-1+, but incidence of all other adverse events did not differ between groups.

conclusionsWe found no additive benefit of rhIGF-1 administration for 12 months over transdermal estrogen replacement alone in this cohort of young women with AN.

Indexed as

Administration, CutaneousAdolescentAnorexia NervosaBiomarkersBone DensityBone RemodelingDouble-Blind MethodDrug Therapy, CombinationEstradiolEstrogen Replacement TherapyEstrogensFemaleHumansInsulin-Like Growth Factor ILongitudinal StudiesTreatment OutcomeBiomarkersEstradiolEstrogensInsulin-Like Growth Factor Iadolescentsanorexia nervosabone densitybone microarchitectureestradiolIGF-1

Identifiers

PMID33693703
PMCPMC8427708
OpenAlexW3134834425

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.