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Incomplete Modified Fast in Obese Early Pubertal Girls Leads to an Increase in 24-Hour Growth Hormone Concentration and a Lessening of the Circadian Pattern in Leptin

Department of Pediatrics, Division of Pediatric Endocrinology (J.Z.K.-V., P.O., T.M., C.M.F.), and Department of Internal Medicine, Division of Endocrinology and Metabolism (A.B.), University of Michigan Medical School, Ann Arbor, Michigan 48019; and Department of Biostatistics, University of Michigan School of Public Health (N.E.C.), Ann Arbor, Michigan 48109

Address all correspondence and requests for reprints to: Dr. Josephine Z. Kasa-Vubu, Department of Pediatrics, Division of Pediatric Endocrinology, University of Michigan Medical Center, 11th Floor, 300 North Ingalls, Ann Arbor, Michigan 48019-0718.

Abstract

We studied nutrition and GH in eight obese girls, aged 6–11 yr. Blood was sampled every 15 min for 24 h. A 48-h diet providing 25% of assumed caloric needs was imposed, with repeat sampling during the last 24 h. Six nonfasting lean girls were also studied, and their mean GH was 3 times that of the obese girls in the fed state (P = 0.024). Dieting increased mean GH by 60% (P = 0.0028). There was no difference in pulse number for either group, but total secretion for lean girls was 3.9 times greater than that in obese girls during the fed state. With dieting, obese girls increased their total GH secretion by 60% (P = 0.010), but maintained lower total secretion, approximately 40% that of lean girls (P = 0.014). Mean leptin in obese girls in the fed state was 6.2 times greater than mean leptin in lean girls (P = 0.0001), with higher concentrations at night (P < 0.05) and lowering of total mean leptin while dieting. We conclude that in early pubertal obese girls, short-term caloric restriction partially reverses the low GH state that is characteristic of obesity. The change is concomitant with a decrease in leptin and a lessening of circadian differences.

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