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Ghrelin levels are decreased in non-obese prepubertal children born large for gestational age

¹ , Pediatric Endocrinology Unit² Social Pediatrics Unit, Department of Pediatrics, Istanbul Faculty of Medicine, Istanbul University, 34390 Istanbul, Turkey

(Correspondence should be addressed to F Darendeliler; Email: feyzad{at}istanbul.edu.tr)

Background: Ghrelin is the natural ligand of GH secretagogue receptor. It has several metabolic functions including regulation of food intake, energy homeostasis, and body weight. An inverse relationship between fasting plasma ghrelin and insulin concentrations has been shown. Being born large for gestational age (LGA) has an increased risk of developing insulin resistance.

Objective: The aim of this study was to evaluate ghrelin levels in LGA born children who have no obesity at prepubertal ages and the effect of intrauterine and postnatal growth on ghrelin levels.

Patients and methods: Thirty-two (17F, 15M) LGA born non-obese children (mean (±S.E.M.) age 4.4±0.3 years) were evaluated with respect to glucose, insulin, and ghrelin levels. Their data were compared with that of non-obese 45 (19F, 26M) appropriate for gestational age (AGA) children (mean (±S.E.M.) age 4.0±0.1 years).

Results: LGA children, who had similar age and body mass index (BMI) standard deviation score (SDS) as AGA children, had significantly higher insulin (P=0.044) and at a borderline significance higher homeostasis model assessment-insulin resistance levels (P=0.054) than AGA children. Ghrelin level was significantly lower in LGA born than AGA born children (P=0.001) even after controlling for age, sex, and BMI (P=0.006). There were no differences between genders in insulin and ghrelin levels. Multivariate analysis revealed that birth weight was the only significant parameter influencing ghrelin levels (R²=0.13, B=–0.007, P=0.002).

Conclusions: LGA born non-obese prepubertal children have lower ghrelin levels when compared with age and BMI matched AGA children. Birth weight seems to have the only significant effect on the reduced ghrelin levels.