Hyperghrelinemia Does Not Accelerate Gastric Emptying in Prader-Willi Syndrome Patients
Yon Ho Choe,
Dong-Kyu Jin,
Sang Eun Kim,
Sang Yong Song,
Kyung Hoon Paik,
Hwa Young Park,
Yoo Joung Oh,
An Hee Kim,
Jung Sim Kim,
Chi Wha Kim,
Su-Hyun Chu,
Eun Kyung Kwon and
Kyung Han Lee
Departments of Pediatrics (Y.H.C., H.Y.P., K.H.P., E.K.K., D.K.J.), Nuclear Medicine (K.H.L.), and Pathology (S.Y.S.), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul; Department of Nuclear Medicine, Seoul National University College of Medicine (S.E.K.), Seoul; and Clinical Research Center, Samsung Biomedical Research Institute (Y.J.O., A.H.K., J.S.K., C.W.K., S.H.C.), Seoul 135-710, Korea
Address all correspondence and requests for reprints to: Dr. Dong-Kyu Jin, 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.
Prader-Willi syndrome (PWS) is the most common form of syndromicobesity associated with hyperphagia. Because ghrelin stimulatesgastric motility in rodents, and PWS patients have 3- to 4-foldhigher fasting plasma ghrelin concentrations than normal subjects,we hypothesized that hyperphagia associated with PWS may bepartly explained by rapid gastric emptying due to the increasedgastric motility caused by ghrelin. We determined gastric emptyingtimes (GETs) and measured ghrelin levels in 11 PWS childrenand 11 age-, sex-, and body mass index-matched controls usinga standard meal containing [99mTc]diaminetriaminepentacetate.Median plasma ghrelin levels before (precibum) and after theGET study were higher in PWS patients than in controls (P =0.004 and P = 0.001, respectively). Median percent gastric retentionsat 90 min after the standard meal were 57.1% (range, 34.0–83.2%)in PWS patients and 40.2% (range, 27.2–60.2%) in controls(P = 0.03). In particular, precibum ghrelin concentrations werenot significantly correlated with the rate of gastric emptyingin PWS patients (P = 0.153; r = 0.461) or controls (P = 0.911;r = 0.048). Our results show that gastric emptying in PWS isreduced despite higher ghrelin levels, and that the voraciousappetite associated with PWS is related to another mechanism.
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