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Effect of Sex Hormone Administration on Circulating Ghrelin Levels in Peripubertal Children

Institute for Endocrinology and Diabetes (Y.L., G.G.-Y., B.S., M.P., L.L.), National Center of Childhood Diabetes, Schneider Children’s Medical Center of Israel and Felsenstein Medical Research Center, Petah Tiqva 49202, Israel; Sackler Faculty of Medicine (Y.L., G.G.-Y., B.S., A.P., M.P., L.L.), Tel Aviv University, Tel Aviv 69978, Israel; and Department of Obstetrics and Gynecology (A.P.), Assaf Harofe Medical Center, Zerifin 70300, Israel

Address all correspondence and requests for reprints to: Moshe Phillip, M.D., Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children’s Medical Center of Israel, 14 Kaplan Street, Petah Tiqva 49202, Israel. E-mail: mosheph{at}post.tau.ac.il.

Background: Ghrelin levels gradually decrease throughout childhood and with advancing pubertal stage. The change during puberty is more pronounced in boys than girls.

Objective: The objective of the study was to investigate whether the pubertal drop in ghrelin secretion is modified by the increase in sex hormones.

Patients and Methods: Ghrelin levels were measured in 34 short peripubertal children (17 boys and 17 girls) aged 8–12.5 yr before and after sex hormone priming for GH stimulation testing.

Results: In boys, priming with testosterone increased testosterone to pubertal levels (23.7 ± 7.1 nmol/liter), which in turn induced a marked decrease in ghrelin (from 1615.8 ± 418.6 to 1390.0 ± 352.0 pg/ml) and leptin (from 8.0 ± 4.5 to 5.8 ± 3.2 ng/ml) and an increase in IGF-I (from 162.7 ± 52.8 to 291.1 ± 101.6 ng/ml) (P < 0.001 for all parameters). In girls, priming with estrogen led to a supraphysiological increase in estradiol levels (1313.8 ± 438.0 pmol/liter), which had no effect on ghrelin, leptin, or IGF-I. There was no correlation between ghrelin levels and levels of sex hormones, leptin, or body mass index in either boys or girls.

Conclusions: A pharmacological increase in sex hormones is associated with a marked decline in circulating levels of ghrelin in boys but not girls. Additional longitudinal studies through puberty are needed to elucidate the physiological interaction between sex hormones and ghrelin.

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