title: Plasma ghrelin and liquid gastric emptying in children with functional dyspepsia consistent with post-prandial distress syndrome.
abstract: BACKGROUND
  Adult studies indicate a role for ghrelin in functional dyspepsia (FD) mediated through ghrelin's effect on gastric emptying (GE). This study examines the relationship between ghrelin, liquid GE, and pain in children with FD.
  
  
  METHODS
  Thirteen FD patients reporting symptoms consistent with post-prandial distress syndrome (PDS) and 17 healthy controls were enrolled. All participants received a liquid meal containing (13) C-sodium acetate. Pain severity, liquid GE utilizing exhaled (13) CO2 from the sodium acetate breath tests (ABT), plasma acyl ghrelin (AG), and des-acyl ghrelin concentrations were measured at specific intervals over 240 min following ingestion.
  
  
  RESULTS
  FD-PDS patients demonstrated lower mean baseline AG (14.8 ± 9.7 vs 27.2 ± 14.0 fmol/mL; p = 0.013), AG Cmax (24.6 ± 8.2 vs 40.5 ± 16.8 fmol/mL; p = 0.007), and AG flux (18.2 ± 7.8 vs 32.7 ± 17.3 fmol/mL; p = 0.015) than controls. The time to reach maximum exhaled (13) CO2 concentration (T max ) was longer in FD patients than controls (47.5 ± 18.5 vs 35.8 ± 11.8 min; p = 0.046). Significant relationships between ghrelin analyte ratios and ABT parameters were largely confined to control participants.
  
  
  CONCLUSIONS
  FD-PDS in children is associated with lower fasting and maximum AG concentrations, and dampened AG flux. These data suggest a possible role for altered ghrelin physiology in the pathogenesis of PDS.
authors.affiliation: Division of Gastroenterology, Hepatology, and Nutrition, Children's Mercy Kansas City, Kansas City, MO, USA.
authors.forename: N M
authors.initials: NM
authors.lastname: Hijaz
authors.affiliation: Division of Gastroenterology, Hepatology, and Nutrition, Children's Mercy Kansas City, Kansas City, MO, USA.
authors.forename: C A
authors.initials: CA
authors.lastname: Friesen
authors.affiliation: Division of Gastroenterology, Hepatology, and Nutrition, Children's Mercy Kansas City, Kansas City, MO, USA.|Division of Developmental & Behavioral Sciences, Children's Mercy Kansas City, Kansas City, MO, USA.
authors.forename: J V
authors.initials: JV
authors.lastname: Schurman
authors.affiliation: Division of Clinical Pharmacology, Toxicology, and Therapeutic Innovation, Children's Mercy Kansas City, Kansas City, MO, USA.
authors.forename: R E
authors.initials: RE
authors.lastname: Pearce
authors.affiliation: Division of Clinical Pharmacology, Toxicology, and Therapeutic Innovation, Children's Mercy Kansas City, Kansas City, MO, USA.
authors.forename: S M
authors.initials: SM
authors.lastname: Abdel-Rahman
mesh_terms: D000293:Adolescent; D001944:Breath Tests; D002247:Carbon Isotopes / Q000008:administration & dosage; D002648:Child; D004415:Dyspepsia / Q000097:blood / Q000503:physiopathology*; D005260:Female; D005746:Gastric Emptying; D054439:Ghrelin / Q000097:blood*; D006801:Humans; D008297:Male; D019518:Postprandial Period; D019346:Sodium Acetate / Q000008:administration & dosage
chemical_list: D002247:Carbon Isotopes; D054439:Ghrelin; D019346:Sodium Acetate
keywords: abdominal pain; acetate breath test; acyl ghrelin; children; functional dyspepsia; liquid gastric emptying; post-prandial distress syndrome