This Article Full Text Full Text (PDF) Submit a related Letter to the Editor Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Reprints, Permissions and Rights Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Hauffa, B. P. Articles by Petersenn, S. Search for Related Content PubMed PubMed Citation Articles by Hauffa, B. P. Articles by Petersenn, S. Related Collections Neuroendocrinology and Pituitary Pediatric Endocrinology Metabolism Obesity

The Effect of Growth Hormone on the Response of Total and Acylated Ghrelin to a Standardized Oral Glucose Load and Insulin Resistance in Children with Prader-Willi Syndrome

Department of Pediatric Hematology/Oncology and Endocrinology, University Children’s Hospital (B.P.H., K.H.), and Department of Endocrinology, University Medical Center (I.M.R., N.U., K.M., S.P.), University of Duisburg-Essen, D-45122 Essen, Germany

Address all correspondence and requests for reprints to: Berthold P. Hauffa, M.D., Ph.D., Department of Pediatric Hematology/Oncology and Endocrinology, University Children’s Hospital, Hufelandstrasse 55, D-45122 Essen, Germany. E-mail: berthold.hauffa{at}uni-essen.de.

Context: Fasting levels of plasma ghrelins are grossly elevated in children with Prader-Willi syndrome (PWS). The cause of this elevation and the regulation of ghrelins in PWS is largely unknown. The regulatory role of individual nutritional components and of GH is not well characterized.

Objective: We investigated the influence of GH on acylated (aGhr) and total ghrelin (tGhr) concentrations before and after an oral glucose load, and on insulin resistance in PWS children.

Design, Patients, and Interventions: In a clinical follow-up study, plasma ghrelins were measured during an oral glucose tolerance test, and parameters of insulin resistance were determined in 28 PWS children before and/or 1.18 (0.42–9.6) yr (median, range) after start of GH therapy (0.035 mg/kg body weight per day).

Main Outcome Measures: Fasting and postglucose concentrations of aGhr and tGhr and homeostasis model assessment 2 insulin resistance were the main outcome measures.

Setting: The study was conducted in a single center (University Children’s Hospital).

Results: High fasting [1060 ± 292 (SD) pg/ml; n = 12] and postglucose trough (801 ± 303 pg/ml; n = 10) tGhr concentrations in GH-untreated PWS children were found to be decreased in the GH-treated group (fasting 761 ± 247 pg/ml, n = 24, P = 0.006; postglucose 500 ± 176 pg/ml, n = 20; P = 0.006). In contrast, aGhr concentrations and insulin resistance were not changed by GH treatment. Both aGhr and tGhr concentrations were decreased by oral carbohydrate administration, independent of the GH treatment status.

Conclusions: Our results indicate that, in PWS children, aGhr and tGhr are differentially regulated by GH.

This article has been cited by other articles:

				L. Pacifico, E. Poggiogalle, F. Costantino, C. Anania, F. Ferraro, F. Chiarelli, and C. Chiesa Acylated and nonacylated ghrelin levels and their associations with insulin resistance in obese and normal weight children with metabolic syndrome Eur. J. Endocrinol., December 1, 2009; 161(6): 861 - 870. [Abstract] [Full Text] [PDF]

				E. Feigerlova, G. Diene, F. Conte-Auriol, C. Molinas, I. Gennero, J.-P. Salles, C. Arnaud, and M. Tauber Hyperghrelinemia Precedes Obesity in Prader-Willi Syndrome J. Clin. Endocrinol. Metab., July 1, 2008; 93(7): 2800 - 2805. [Abstract] [Full Text] [PDF]