Table 1.

Potential hormonal determinants of marrow adipose tissue (MAT) in anorexia nervosa

	Hormone levels in anorexia nervosa (compared to normal weight individuals)	Association with bone	Association with MAT
Cortisol	Elevated [24-27]	Inversely associated with BMD [27, 64]	No known association in AN
Preadipocyte factor-1	Elevated [29]	Inversely associated with BMD [29]	Positive association with MAT in AN [29]
Estrogen	Low [64]	Duration of amenorrhea inversely associated with BMD [64]	Estrogen suppresses MAT in postmenopausal women (unknown in AN) [32]
Fibroblast growth factor 21	Similar/low [38, 65, 66]	Inversely associated with parameters of bone microarchitecture [38]	Inverse association with MAT [39]
Ghrelin	Elevated [40-42]	Positive association with BMD in normal weight individuals but inverse association with BMD in AN [67, 68]	Stimulates marrow adipogenesis in rodent models [43]
Leptin	Low [45, 46]	Positively associated with BMD and parameters of bone microarchitecture [29, 47, 48]	Inverse association with MAT [29]
IGF-1	Low [49]	Positively associated with BMD [53]	Inverse association with MAT in AN [29]
IGFBP2	Elevated [49, 54, 55]	Inversely associated with BMD and osteocalcin (marker of bone formation) [29, 54]	Positive association with MAT [29]
Adiponectin	Majority of studies demonstrate elevated total adiponectin levels [58, 59]	Inversely associated with BMD in AN [69]	Adiponectin secreted by MAT in animal models [59]