Total and Acylated Ghrelin Levels in Children With Poor Growth

Abstract

Ghrelin, an enteric hormone with potent appetite stimulating effects, also stimulates growth hormone release. We hypothesized that altered levels of total ghrelin (TG) or acylated ghrelin (AG) could affect growth by altering growth hormone secretion, subsequently affecting insulin-like growth factor-1 (IGF-1) generation or by altering appetite and food intake. After institutional review board approval, 52 children presenting for evaluation of chronic gastrointestinal symptoms (group 1), poor weight gain (group 2), or poor linear growth (group 3) were evaluated for fasting TG and AG levels in addition to their regular evaluation. Serum ghrelin, IGF-1, and prealbumin were compared between groups. No difference was observed for mean fasting TG between groups. However, mean fasting AG was highest in patients in group 2 (465 Ϯ 128 pg/mL) versus group 1 (176 Ϯ 37 pg/mL) and group 3 (190 Ϯ 34 pg/mL). IGF-1 was lowest in patients in group 2 despite similar prealbumin levels among the three groups. We conclude that serum AG levels are highest in children with isolated poor weight gain compared with children with short stature or chronic gastrointestinal symptoms, suggesting the possibility of resistance to AG in underweight children. Additional studies are needed to further clarify ghrelin's role in growth and appetite. (Pediatr Res 69: 517-521, 2011)

The Effect of Helicobacter Pylori Infection on Plasma Ghrelin and on AnthropometrY Dyspeptic Children

“…While no children whose height was under percentile 10 were present in H. pylori (-) group in our study, the fact that there were 10 Endogenous ghrelin was shown to stimulate GH secretion from the pituitary gland by activating its receptor (23). Ghrelin may not only play a part in triggering GH release, but could also contribute to positive energy balance by increasing appetite, and these effects, together or separately, could affect growth and weight gain (10). However, the data related to the association between H. pylori infection and plasma level of ghrelin are controversial.…”

“…H. pylori infection is associated with growth failure and possibly lower ghrelin levels (10). On the other hand, the likelihood of the association between H. pylori and growth failure still remains controversial (11)(12)(13)(14)(15)(16)(17).…”

“…Pinsker et al (10) proposed that ghrelin may affect growth via two different ways: first, by altering GH secretion and subsequently affecting insulin-like growth factor (IGF)-1 generation and second, by stimulating appetite and food intake. Both decreased level of plasma ghrelin in H. pylori (+) group and the existence of a negative correlation between appetite and C-14 UBT levels were supporting the reviews of Pinsker et al Therewithal, these results are consistent with those of Shiotani et al (28), reporting that H. pylori-infected individuals had a lower plasma ghrelin concentration in their study.…”

“…Potential relationships between gastrointestinal disease associated with H. pylori, and ghrelin, growth and appetite still remain unclear, because other factors like socioeconomic status may also be involved (10)(11)(12).…”

The endocrine effects of acylated and des-acylated ghrelin

“…26 In addition, no difference in ghrelin levels has been noted between normal and GH-deficient individuals. [27][28][29] Interestingly, AG levels were higher in children with poor weight gain than in those with short stature or chronic gastrointestinal dysfunctions, 30 indicating that AG would be released in response to an energy deficit rather than being submit your manuscript | www.dovepress.com influenced by growth defects per se. Consequently, this either suggests that ghrelin is not essential for the regulation of normal growth functions or that other factors could compensate for its deficient secretion.…”