Circulating ghrelin levels in girls with central precocious puberty are reduced during treatment with LHRH analog

Abstract

Decreased levels of ghrelin have been measured in growing children during puberty. No data are available for girls with central precocious puberty (CPP). Aims: To explore ghrelin changes before, during, and after GnRH analog treatment in girls with CPP. Subjects and methods: A sample of 20 Caucasian girls (8.08G0.65 years of age) with CPP was recruited. Height and weight, bone age, LH, FSH, 17b estradiol (E 2 ), and ghrelin were measured before starting treatment with GnRH analog, 18 months after therapy began and again 6 months after therapy discontinuation. Results: LH and E 2 serum levels decreased significantly during treatment (2.45G2.03 vs 0.67G 0.49 UI/l, P!0.01 and 28.17G9.7 vs 15 pmol/l, P!0.01 respectively), returning to baseline levels after the discontinuation of therapy (4.75G1.66 UI/l and 29.23G6.99 pmol/l respectively). LH peaked following LHRH stimulation significantly (P!0.01) decreased during treatment (24.45G 14.17 vs 1.3G0.18 UI/l) and then increased after therapy discontinuation (12.58G6.09, P!0.01). Ghrelin decreased significantly (P!0.05) during treatment (1849G322 vs 1207G637 pg/ml), and increased, though not significantly (PZ0.09) after therapy withdrawal (1567G629 pg/ml). Conclusions:Contrary to what is expected in physiologic puberty, where ghrelin is progressively reduced, the prepubertal hormone milieau induced by GnRHa treatment in patients suffering from central precocious puberty (CPP) did not promote an increase in ghrelin circulating levels. Therefore, in CPP, ghrelin secretion seems to be independent from pubertal development per se. Concomitant estrogen suppression during treatment may play a potential role in the regulation of ghrelin secretion in these girls. European Journal of Endocrinology 156 99-103

Gender Difference of Circulating Ghrelin and Leptin Concentrations in Chronic Helicobacter pylori Infection

“…Present study enrolled the largest number of patients in published English articles and it agrees with gender difference on plasma ghrelin level ( Table 1). The probable explanation for this difference is the effect of sex hormone, because some reports show that estrogen potentially induces ghrelin production and, in contrast, testosterone decrease ghrelin secretion [20][21][22][23]. Our observations show females with higher ghrelin levels than males as supported by Makovey et al, of which 79 pairs of opposite sex twins were included [12].…”

Changes of ghrelin following oral glucose tolerance test in obese children with insulin resistance

“…Contrary to what is expected in physiologic puberty, where ghrelin is progressively reduced, in central precocious puberty (CPP), ghrelin secretion seems to be independent from pubertal development. Concomitant estrogen suppression during treatment may play a potential role in the regulation of ghrelin secretion in CPP girls [20] . With advancing pubertal stages, ghrelin levels may be prone to be influenced by sexual hormones and growth hormone, so they display gender differences.…”

Integrating GHS into the Ghrelin System

“…Gastric ghrelin-secreting cells express estrogen receptor-alpha [103], thus potentially mediating some sex-steroid effects. Indeed, gonadal downregulation in girls and parenteral (but not transdermal) testosterone administration in boys diminish plasma ghrelin concentrations [104, 105]. In addition, clinical investigations indicate that E 2 or T supplementation can potentiate GH secretion stimulated by a fixed submaximal dose of GHS/ghrelin [106–112].…”