Ghrelin and feeding behaviour in preterm infants

Abstract

a b s t r a c t a r t i c l e i n f o Available online xxxx Keywords: Ghrelin Feeding behaviour Preterm infantThe importance of early life events in the development of metabolic diseases is well recognized. Early postnatal environment, including nutrition, is key to future health, and this is particularly true for preterm infants. It is important that these infants receive sufficient nutrients to prevent growth restriction and promote neurodevelopment, while minimizing predisposition to metabolic diseases later in life. Feeding habits are the fundamental elements of nutrition and are influenced by many factors, including personal and familial habits, socioeconomic status, and cultural environment. In the last decades, there has been an important scientific interest toward the comprehension of the molecular and neural mechanisms regulating appetite. In these networks, act many peptide hormones produced in brain or gut, among which ghrelin is important because of its action in the short-term regulation of food intake and the long-term regulation of body weight. Ghrelin stimulates appetite and plays a role in regulating feeding behaviour. Ghrelin levels vary from fetal life through to early adulthood, with the highest levels observed in the very early years. Cord ghrelin levels have been evaluated in term and preterm newborns and high ghrelin levels have been observed in smallfor-gestational age newborns and in newborns with intrauterine growth restriction. Moreover, ghrelin has been detected in term and preterm human breast milk, suggesting that it may play a role in the development of neuroendocrine pathways regulating appetite and energy homeostasis in early life. However, more research is required to better define ghrelin's role in breast milk and on feeding behaviour.

Ghrelin and Obestatin in Infants, Lactating Mothers and Breast Milk

“…The recent identification of ghrelin and obestatin in breast milk [9,10], together with adipokines [11], suggests that all these factors may have a long-term effect on the regulation of feeding behavior, metabolism and energy balance [12,13]. …”

Rapid gut growth but persistent delay in digestive function in the postnatal period of preterm pigs

“…It remains unknown how different organ systems adapt in preterm infants and when parameters of structure and function become similar to those in term infants. For gastrointestinal (GI) functions, eating disorders and dysregulated appetite have been reported in preterm infants (44) but very little is known about the long-term adaptation of the GI tract in preterm neonates.…”

Response of metabolic hormones and blood metabolites to realimentation in rehabilitated harbor seal (Phoca vitulina) pups

“…In contrast, ghrelin concentrations in this study actually increased from nutritional nadir (week 0) to week 4-8 when animals were fed. Given that ghrelin is vital for lipid synthesis and deposition (Sangiao-Alvarellos et al 2011), it is possible that the increased in ghrelin concentrations upon realimentation is a mechanism facilitating compensatory accumulation of lipids after periods of nutritional deprivation (Savino et al 2012). This increase in ghrelin may also result in a hyperphagic response allowing increased appetite and consumption regardless of energy status (Tanaka et al 2002).…”