BACKGROUND: Prader-Willi syndrome (PWS) is associated with failure to thrive in infancy and progressive hyperphagia and obesity in childhood. This progressive weight gain is associated with hyperghrelinaemia and increased insulin sensitivity. The role of ghrelin excess in the pathogenesis of obesity is unclear. OBJECTIVE: To determine if high ghrelin levels precede the onset of obesity in young PWS children. DESIGN AND METHODS: A cross-sectional study of 33 infants with PWS and 28 healthy control subjects (C). Fasting ghrelin and other satiety hormones were measured. RESULTS: Median total serum ghrelin in young children with PWS trended higher, but did not differ significantly from those in C of similar age, weight-for-age z-score and sex. However, there was more variability in ghrelin concentrations of young PWS. Eleven of 33 PWS subjects had ghrelin levels greater than the 95th percentile for ghrelin values in the C subjects (> 2871 pg/ml). Six of the PWS subjects with high ghrelin levels had weight-for-age z-scores < 0. Ghrelin concentrations in PWS and C infants exceeded those in older children. In youngsters with PWS, leptin was higher, suggesting a relative excess of fat to lean body mass and plasma adiponectin was increased. CONCLUSIONS: Young infants with PWS who have not yet developed hyperphagia or obesity have median fasting ghrelin levels similar to controls. However, a subset (33%) of young PWS is hyperghrelinaemic; approximately one-half of those with hyperghrelinaemia have BMI z-score < 0. The age-related decline in ghrelin is blunted in PWS.
BACKGROUND:Prader-Willi syndrome (PWS) is associated with failure to thrive in infancy and progressive hyperphagia and obesity in childhood. This progressive weight gain is associated with hyperghrelinaemia and increased insulin sensitivity. The role of ghrelin excess in the pathogenesis of obesity is unclear. OBJECTIVE: To determine if high ghrelin levels precede the onset of obesity in young PWSchildren. DESIGN AND METHODS: A cross-sectional study of 33 infants with PWS and 28 healthy control subjects (C). Fasting ghrelin and other satiety hormones were measured. RESULTS: Median total serum ghrelin in young children with PWS trended higher, but did not differ significantly from those in C of similar age, weight-for-age z-score and sex. However, there was more variability in ghrelin concentrations of young PWS. Eleven of 33 PWS subjects had ghrelin levels greater than the 95th percentile for ghrelin values in the C subjects (> 2871 pg/ml). Six of the PWS subjects with high ghrelin levels had weight-for-age z-scores < 0. Ghrelin concentrations in PWS and C infants exceeded those in older children. In youngsters with PWS, leptin was higher, suggesting a relative excess of fat to lean body mass and plasma adiponectin was increased. CONCLUSIONS: Young infants with PWS who have not yet developed hyperphagia or obesity have median fasting ghrelin levels similar to controls. However, a subset (33%) of young PWS is hyperghrelinaemic; approximately one-half of those with hyperghrelinaemia have BMI z-score < 0. The age-related decline in ghrelin is blunted in PWS.
Authors: David E Cummings; Karine Clement; Jonathan Q Purnell; Christian Vaisse; Karen E Foster; R Scott Frayo; Michael W Schwartz; Arnaud Basdevant; David S Weigle Journal: Nat Med Date: 2002-07 Impact factor: 53.440
Authors: J A Janssen; F M van der Toorn; L J Hofland; P van Koetsveld; F Broglio; E Ghigo; S W Lamberts; A Jan van der Lely Journal: Eur J Endocrinol Date: 2001-12 Impact factor: 6.664
Authors: A M Wren; L J Seal; M A Cohen; A E Brynes; G S Frost; K G Murphy; W S Dhillo; M A Ghatei; S R Bloom Journal: J Clin Endocrinol Metab Date: 2001-12 Impact factor: 5.958
Authors: N Murakami; T Hayashida; T Kuroiwa; K Nakahara; T Ida; M S Mondal; M Nakazato; M Kojima; K Kangawa Journal: J Endocrinol Date: 2002-08 Impact factor: 4.286
Authors: A P Goldstone; E L Thomas; A E Brynes; J D Bell; G Frost; N Saeed; J V Hajnal; J K Howard; A Holland; S R Bloom Journal: J Clin Endocrinol Metab Date: 2001-09 Impact factor: 5.958
Authors: Krystal A Irizarry; James Bain; Merlin G Butler; Olga Ilkayeva; Michael Muehlbauer; Andrea M Haqq; Michael Freemark Journal: Clin Endocrinol (Oxf) Date: 2015-04-01 Impact factor: 3.478
Authors: Andrea M Haqq; Michael J Muehlbauer; Christopher B Newgard; Steven Grambow; Michael Freemark Journal: J Clin Endocrinol Metab Date: 2010-10-20 Impact factor: 5.958
Authors: Roja Motaghedi; Elizabeth G Lipman; Jeannette E Hogg; Paul J Christos; Maria G Vogiatzi; Moris A Angulo Journal: Eur J Med Genet Date: 2010-10-20 Impact factor: 2.708
Authors: Jennifer L Miller; Christy H Lynn; Danielle C Driscoll; Anthony P Goldstone; June-Anne Gold; Virginia Kimonis; Elisabeth Dykens; Merlin G Butler; Jonathan J Shuster; Daniel J Driscoll Journal: Am J Med Genet A Date: 2011-04-04 Impact factor: 2.802
Authors: Pinar Gumus Balikcioglu; Metin Balikcioglu; Michael J Muehlbauer; Jonathan Q Purnell; David Broadhurst; Michael Freemark; Andrea M Haqq Journal: J Clin Endocrinol Metab Date: 2015-08-10 Impact factor: 5.958
Authors: R Geoffrey Burwell; Ranjit K Aujla; Michael P Grevitt; Peter H Dangerfield; Alan Moulton; Tabitha L Randell; Susan I Anderson Journal: Scoliosis Date: 2009-10-31