Marked suppression of ghrelin concentration by insulin in Prader-willi syndrome.
The plasma ghrelin has been reported to be elevated in Prader-Willi syndrome (PWS) and modulated by insulin. It was hypothesized that insulin might have a more pronounced effect on reducing plasma ghrelin in PWS patients, which would influence appetite. This study investigated the degree of ghrelin suppression using an euglycemic hyperinsulinemic clamp in children with PWS (n=6) and normal children (n=6). After a 90-min infusion of insulin, the plasma ghrelin level decreased from a basal value of 0.86+/-0.15 to 0.58+/-0.12 ng/mL in the controls, and from 2.38+/-0.76 to 1.12+/-0.29 ng/mL in children with PWS (p=0.011). The area under the curve below the baseline level over the 90 min insulin infusion was larger in children with PWS than in controls (-92.82+/-44.4 vs. -10.41+/-2.87 ng/mL/90 min) (p=0.011). The insulin sensitivity measured as the glucose infusion rate at steady state was similar in the two groups (p=0.088). The decrease in the ghrelin levels in response to insulin was more pronounced in the children with PWS than in the controls. However, the level of ghrelin was always higher in the children with PWS during the clamp study. This suggests that even though insulin sensitivity to ghrelin is well maintained, an increase in the baseline ghrelin levels is characteristic of PWS.
Paik
Kyung-Hoon
KH
Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Lee
Moon-Kyu
MK
Jin
Dong-Kyu
DK
Kang
Hahn Wook
HW
Lee
Kyung Han
KH
Kim
An Hee
AH
Kim
Cheol
C
Lee
Ji Eun
JE
Oh
Yoo Joung
YJ
Kim
Seonwoo
S
Han
Sun Joo
SJ
Kwon
Eun Kyung
EK
Choe
Yon Ho
YH
D000293:Adolescent; D002648:Child; D015536:Down-Regulation / Q000187:drug effects; D005260:Female; D054439:Ghrelin; D006801:Humans; D007262:Infusions, Intravenous; D007328:Insulin / Q000008:administration & dosage* / Q000097:blood; D008297:Male; D008657:Metabolic Clearance Rate / Q000187:drug effects; D036361:Peptide Hormones / Q000097:blood* / Q000187:drug effects*; D011218:Prader-Willi Syndrome / Q000097:blood*
D054439:Ghrelin; D007328:Insulin; D036361:Peptide Hormones