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

Departments of Pediatrics (K.H.P., D.-K.J., Y.H.C., S.H.Ko., S.M.S., S.H.L., S.H.Ki., E.K.K.) and Pathology (S.Y.S.), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, Korea; Clinical Research Center (J.S.K., Y.J.O., S.W.K.), Samsung Biomedical Research Institute, Seoul 135-710, Korea; and Department of Pediatrics (J.E.L.), College of Medicine, Inha University, Incheon 400-711, Korea

Address all correspondence and requests for reprints to: Dong-Kyu Jin, M.D., Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Il-Won Dong, Gang-Nam Gu, Seoul 135-710, Korea. E-mail: jindk{at}smc.samsung.co.kr.

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.

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