Correlation between Fasting Plasma Ghrelin Levels and Age, Body Mass Index (BMI), BMI Percentiles, and 24-Hour Plasma Ghrelin Profiles in Prader-Willi Syndrome

Abstract

Ghrelin is a GH-releasing acylated peptide found in the stomach and a centrally acting food intake stimulator. Prader-Willi syndrome (PWS) is a genetic disorder characterized by a voracious appetite and increased fasting ghrelin levels. In this report we describe 24-h ghrelin profiles in PWS children (n = 5) and compare these with age, sex, and body mass index (BMI)-matched controls (n = 5). A 3- to 4-fold increase in ghrelin levels was found in PWS over a 24-h period, compared with controls (P < 0.001). Interestingly, there was a greater tendency for the up-regulation of ghrelin level in lean PWS than in obese PWS. To confirm this finding, we measured fasting ghrelin levels in 39 patients with PWS. Inverse correlations were found between plasma ghrelin levels and the following: age (r = -0.408, P = 0.005), BMI (r = -0.341, P = 0.017), percentage of the ideal weight for age (r = -0.382, P = 0.008), and BMI percentile (r = -0.311, P = 0.027). Our data show that there may be a suppressive (or up-regulating) controlling mechanism of ghrelin secretion in obese (or lean) PWS children. We hope that our data may further explain the mechanisms underlying the insatiable appetite and obesity characteristic of PWS.

Appetite hormones and the transition to hyperphagia in children with Prader-Willi syndrome

“…26,27,32,34,36 --38,40,43 --48 Levels of ghrelin do fall after food intake in children and adults with PWS but remain elevated compared with the controls relative to their obesity. 37,38,40,43,44 In our current study, we were unable to demonstrate any elevation of plasma ghrelin levels in PWS children under 5 years, unadjusted or when correcting for age, BMI, fasting insulin or insulin resistance. This finding is in agreement with previous studies of PWS children aged under 3 or 5 years, 39,42,46 although it should be noted that one of these studies did not find hyperghrelinaemia in PWS children over 3 years and adults either.…”

Ghrelin in obesity and endocrine diseases

“…( Bizzarri et al, 2010;Cummings et al, 2002b;Gimenez-Palop et al, 2007;Goldstone et al, 2005;Haqq et al, 2003a;Paik et al, 2004). Levels of fasting ghrelin may also even be higher in PWS patients than in lean controls (Bizzarri et al, 2010;Choe et al, 2005a;Cummings et al, 2002b;Delparigi et al, 2002;Gimenez-Palop et al, 2007).…”

Abordagem terapêutica da obesidade na Síndrome de Prader-Willi

“…Um estudo que comparou os níveis de ghrelina entre 5 pacientes com SPW e 5 controles normais ajustados para idade, sexo e IMC, observou que o nível de ghrelina era 3 a 4 vezes maior nos pacientes com SPW (22). Sabe-se que a somatostatina é um peptídeo que inibe a secreção de ghrelina pelas células do fundo gástrico; entretanto, a administração de somatostatina a indivíduos com SPW não se mostrou eficaz na redução da ingestão alimentar, embora tenha reduzido os ní-veis séricos de ghrelina e de neuropeptídeo Y e causado hiperglicemia pós-prandial nesses pacientes (23).…”