title: Changes of peripheral alpha-melanocyte-stimulating hormone in childhood obesity.
abstract: Relationships of blood circulating melanocortins to childhood obesity are not well established. We evaluated serum alpha-melanocyte-stimulating hormone (alpha-MSH) in lean children and different study groups of childhood obesity. We examined serum alpha-MSH in 52 otherwise healthy children with childhood obesity (Ob; mean age, 11 years; 32 girls/20 boys), 27 normal-weight children of same age, 7 additional obese patients with reduced melanocortin-4 receptor function (MC4Rmut), and 22 patients with craniopharyngioma (CP). Fasting serum alpha-MSH and leptin were measured by radioimmunoassay. Serum alpha-MSH was also evaluated 1 hour after 500-kcal liquid meal (CP and Ob) and at the end of 1-year lifestyle intervention in 24 Ob patients. The alpha-MSH levels were similar in obese vs lean children but significantly lower in CP (P < .001) and significantly higher (P < .05) in MC4Rmut patients compared with Ob. One hour after liquid meal, alpha-MSH increased in patients with Ob but not with CP. After 1 year, alpha-MSH levels increased significantly in the successful weight reduction Ob subgroup despite unchanged cortisol levels. The alpha-MSH changes correlated to weight status changes (r = 0.67, P = .0003) but not to changes of cortisol, insulin, or homeostasis model assessment of insulin resistance index. Persistently low alpha-MSH levels in CP patients are suspected to be due to pituitary or hypothalamic damage. High peripheral levels in MC4Rmut carriers indicate up-regulation of alpha-MSH. Changes of weight status are associated with changes of peripheral alpha-MSH.
authors.affiliation: Division of Endocrinology, Seattle Children's Hospital Research Institute, Seattle, WA 98101, USA. christian.roth@seattlechildrens.org
authors.forename: Christian L
authors.initials: CL
authors.lastname: Roth
authors.forename: Pablo J
authors.initials: PJ
authors.lastname: Enriori
authors.forename: Ursel
authors.initials: U
authors.lastname: Gebhardt
authors.forename: Anke
authors.initials: A
authors.lastname: Hinney
authors.forename: Hermann L
authors.initials: HL
authors.lastname: Müller
authors.forename: Johannes
authors.initials: J
authors.lastname: Hebebrand
authors.forename: Thomas
authors.initials: T
authors.lastname: Reinehr
authors.forename: Michael A
authors.initials: MA
authors.lastname: Cowley
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D001835:Body Weight; D002648:Child; D003397:Craniopharyngioma / Q000097:blood; D005260:Female; D005838:Genotype; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D020738:Leptin / Q000097:blood; D008297:Male; D009154:Mutation; D009765:Obesity / Q000097:blood* / Q000235:genetics / Q000628:therapy; D010911:Pituitary Neoplasms / Q000097:blood; D044105:Receptor, Melanocortin, Type 4 / Q000235:genetics; D000521:alpha-MSH / Q000097:blood*
chemical_list: D007328:Insulin; D020738:Leptin; D044105:Receptor, Melanocortin, Type 4; D000521:alpha-MSH; D006854:Hydrocortisone