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Ghrelin Secretion in Childhood Is Refractory to the Inhibitory Effect of Feeding

Units of Pediatrics (S.B., N.C., A.R., D.V., G.B.), Department of Medical Sciences, University of Piemonte Orientale, 28100 Novara, Italy; Division of Endocrinology (F.B.), Department of Internal Medicine, Erasmus University of Rotterdam, 3000 DR Rotterdam, The Netherlands; Division of Endocrinology (F.B., C.G., E.G.), Department of Internal Medicine, University of Turin, 10126 Turin, Italy; Department of Paediatrics (G.R.), Regional Hospital, 39100 Bolzano, Italy; and Division of Pediatric Endocrinology (J.B.), Regina Margherita Children’s Hospital, 10100 Turin, Italy

Address all correspondence and requests for reprints to: Gianni Bona, M.D., Unit of Pediatrics, Department of Medical Sciences, University of Piemonte Orientale "A. Avogadro", Corso Mazzini 18, 28100 Novara, Italy. E-mail: gianni.bona{at}maggioreosp.novara.it.

Ghrelin, a natural GH secretagogue, is predominantly produced by the stomach. Ghrelin has other actions including orexant activity, modulation of energy balance, and modulation of endocrine and nonendocrine functions. Ghrelin secretion is increased by fasting and energy restriction but decreased by food intake, glucose, insulin, and somatostatin. Ghrelin secretion does not seem to be a function of age; in fact, morning ghrelin levels after overnight fasting in prepubertal and pubertal children are similar to those in young adults. To clarify whether children and adults have the same sensitivity to the inhibitory effect of food intake, we studied the ghrelin response to a standardized light breakfast (SLB) in 10 prepubertal lean children whose results were compared with those recorded in 19 normal-weight adults. Basal ghrelin levels in children (median, 224.5; 25th to 75th percentile, 122.0–447.7 pg/ml) and adults (338.0; 238.0–512.0 pg/ml) were similar. SLB inhibited ghrelin levels in adults (263.0; 190.0–399.0 pg/ml). However, no change in ghrelin levels after SLB (206.5; 105.0–274.0 pg/ml) was recorded in children. Thus, food intake inhibits ghrelin secretion in adults but not in children. Ghrelin refractoriness to inhibition by food intake in children would reflect a peculiar functional profile of the ghrelin system in childhood.

This study was partially supported by grants from Ministero dell’Istruzione, dell’Università, della Ricerca, University of Turin, and Studio delle Malattie Endocrino-Metaboliche Foundation.

Abbreviations: BMI, Body mass index; CV, coefficient of variation; GHS-R, GH secretagogue receptor; SLB, standardized light breakfast.

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