title: Increased acyl ghrelin but decreased total ghrelin and unacyl ghrelin in Chinese Han people with impaired fasting glucose combined with impaired glucose tolerance.
abstract: We assessed the plasma acyl ghrelin (AG), unacyl ghrelin (UAG), and total ghrelin (TGhr) levels in Chinese adults with pre-diabetes and newly diagnosed diabetes mellitus (NDDM) after an oral glucose tolerance test (OGTT), and abdominal subcutaneous fat area and visceral fat area (VFA) were measured. Fasting AG level was increased in the impaired fasting glucose (IFG) combined with impaired glucose tolerance (IFG+IGT) and NDDM groups. AG, UAG, and TGhr levels were significantly decreased post-OGTT, and the decrements of 30-min AG, UAG, and TGhr post-OGTT were not significantly different among groups. UAG and TGhr levels did not differ significantly among the normal glucose tolerance (NGT), IFG and NDDM groups, but they decreased obviously in the IFG+IGT and impaired glucose tolerance (IGT) groups. The NDDM group had larger VFA than the NGT, IGT, and IFG+IGT groups, even after adjustment for height, it was still larger than the NGT group. The factors such as dyslipidemia and obesity which are prone to develop insulin resistance (IR) and decrease insulin sensitivity (IS) were negatively correlated with UAG and TGhr, positively with AG/UAG, while no correlations with AG. In terms of evaluating IS and IR, AG/UAG ratio may be superior in AG concentration. Our findings suggest that relative sufficiency of AG, the deficiency of TGhr and UAG are already present in IFG+IGT patients. We speculate that there is UAG resistance in severe hyperglycemia (diabetic state), which could produce elevated TGhr and UAG compared to IFG+IGT group. In the development of T2D, increase of VFA could be the initiating factor, leading elevated AG, reduced UAG, IR, decreased IS, and finally hyperglycemia.
authors.affiliation: Division of Endocrinology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China.
authors.forename: Li
authors.initials: L
authors.lastname: Huang
authors.affiliation: Department of Clinical Medicine, West China School of Medicine, Sichuan University, Chengdu, Sichuan 610041, China.
authors.forename: Yuzhen
authors.initials: Y
authors.lastname: Tong
authors.affiliation: Division of Endocrinology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China.
authors.forename: Fang
authors.initials: F
authors.lastname: Zhang
authors.affiliation: Division of Endocrinology and Metabolism, Chengdu Fifth People's Hospital, Chengdu, Sichuan 611130, China.
authors.forename: Qiu
authors.initials: Q
authors.lastname: Yang
authors.affiliation: Chengdu Yincao Community Hospital, Chengdu, Sichuan 611130, China.
authors.forename: Daigang
authors.initials: D
authors.lastname: Li
authors.affiliation: Chengdu Aerospace Hospital, Chengdu, Sichuan 610100, China.
authors.forename: Shugui
authors.initials: S
authors.lastname: Xie
authors.affiliation: Division of Endocrinology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Li
authors.affiliation: Division of Endocrinology and Metabolism, Chengdu Fifth People's Hospital, Chengdu, Sichuan 611130, China.
authors.forename: Hongyi
authors.initials: H
authors.lastname: Cao
authors.affiliation: Division of Endocrinology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China.
authors.forename: Lizhi
authors.initials: L
authors.lastname: Tang
authors.affiliation: Laboratory of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China.
authors.forename: Xiangxun
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Division of Endocrinology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China. Electronic address: buddyjun@hotmail.com.
authors.forename: Nanwei
authors.initials: N
authors.lastname: Tong
mesh_terms: D000215:Acylation; D000328:Adult; D000368:Aged; D044466:Asian People; D001786:Blood Glucose / Q000032:analysis*; D002681:China; D005215:Fasting / Q000097:blood*; D005260:Female; D054439:Ghrelin / Q000097:blood* / Q000737:chemistry / Q000378:metabolism; D005951:Glucose Tolerance Test; D006801:Humans; D008297:Male; D008875:Middle Aged
chemical_list: D001786:Blood Glucose; D054439:Ghrelin
keywords: Acyl ghrelin; Insulin resistance; Newly diagnosed diabetes mellitus; Pre-diabetes; Visceral fat area