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Serum ghrelin levels are suppressed in hypopituitary patients following insulin-induced hypoglycaemia irrespective of GH status.
Clin Endocrinol (Oxf). 2006 Aug; 65(2):210-4.CE

Abstract

OBJECTIVE

Circulating ghrelin is suppressed during insulin-induced hypoglycaemia in healthy subjects, but it is unknown whether this is determined by feedback inhibition from counter-regulatory hormones. We therefore investigated the impact of GH and cortisol on ghrelin secretion during insulin-induced hypoglycaemia.

DESIGN

Serum levels of ghrelin, GH, and cortisol were measured in 41 adult patients with suspected hypopituitarism during insulin-induced hypoglycaemia. Based on their peak GH response (cut-off level: 3 microg/l), the patients were divided into a GH-sufficient group (GHS) and a GH-deficient group (GHD).

RESULTS

The GHS patients (n = 16) were younger (P < 0.01), had lower baseline cortisol levels [255 +/- 37 vs. 372 +/- 38 nmol/l (P = 0.04)], and tended to have a lower body mass index (P = 0.09) as compared to GHD patients (n = 25). By definition, peak GH (microg/l) was higher in GHS patients [15.0 +/- 1.8 vs. 1.0 +/- 0.2 (P < 0.0001)]. The increase in serum cortisol during the ITT (insulin-tolerance test) was higher and occurred later in GHS patients [Cmax (nmol/l): 561 +/- 41 vs. 412 +/- 50 (P = 0.04); Tmax (minutes): 65 +/- 5 vs. 49 +/- 5 (P = 0.03)]. Serum ghrelin levels changed significantly with time during ITT in both groups (P < 0.0001), characterized by a moderate decline during the initial 50-60 min and a return to baseline after 2 h. No significant differences were recorded in AUCghrelin during the ITT between the two groups. No gender differences in ghrelin levels were recorded.

CONCLUSIONS

(i) Like in healthy subjects serum ghrelin levels are suppressed during an ITT in patients with suspected hypopituitarism. (ii) The suppression of ghrelin was similar in GHD and GHS subjects and was not determined by cortisol. (iii) We hypothesize that insulin rather than hypoglycaemia accounts for ghrelin suppression during an ITT.

Authors+Show Affiliations

Medical Department M and Medical Research Laboratories, Clinical Institute, Aarhus University Hospital, Aarhus, Denmark.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16886962

Citation

Ryber, Louise, et al. "Serum Ghrelin Levels Are Suppressed in Hypopituitary Patients Following Insulin-induced Hypoglycaemia Irrespective of GH Status." Clinical Endocrinology, vol. 65, no. 2, 2006, pp. 210-4.
Ryber L, Obrink K, Houe N, et al. Serum ghrelin levels are suppressed in hypopituitary patients following insulin-induced hypoglycaemia irrespective of GH status. Clin Endocrinol (Oxf). 2006;65(2):210-4.
Ryber, L., Obrink, K., Houe, N., Frystyk, J., & Jørgensen, J. O. (2006). Serum ghrelin levels are suppressed in hypopituitary patients following insulin-induced hypoglycaemia irrespective of GH status. Clinical Endocrinology, 65(2), 210-4.
Ryber L, et al. Serum Ghrelin Levels Are Suppressed in Hypopituitary Patients Following Insulin-induced Hypoglycaemia Irrespective of GH Status. Clin Endocrinol (Oxf). 2006;65(2):210-4. PubMed PMID: 16886962.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Serum ghrelin levels are suppressed in hypopituitary patients following insulin-induced hypoglycaemia irrespective of GH status. AU - Ryber,Louise, AU - Obrink,Kristina, AU - Houe,Nanna, AU - Frystyk,Jan, AU - Jørgensen,Jens Otto Lunde, PY - 2006/8/5/pubmed PY - 2006/12/9/medline PY - 2006/8/5/entrez SP - 210 EP - 4 JF - Clinical endocrinology JO - Clin. Endocrinol. (Oxf) VL - 65 IS - 2 N2 - OBJECTIVE: Circulating ghrelin is suppressed during insulin-induced hypoglycaemia in healthy subjects, but it is unknown whether this is determined by feedback inhibition from counter-regulatory hormones. We therefore investigated the impact of GH and cortisol on ghrelin secretion during insulin-induced hypoglycaemia. DESIGN: Serum levels of ghrelin, GH, and cortisol were measured in 41 adult patients with suspected hypopituitarism during insulin-induced hypoglycaemia. Based on their peak GH response (cut-off level: 3 microg/l), the patients were divided into a GH-sufficient group (GHS) and a GH-deficient group (GHD). RESULTS: The GHS patients (n = 16) were younger (P < 0.01), had lower baseline cortisol levels [255 +/- 37 vs. 372 +/- 38 nmol/l (P = 0.04)], and tended to have a lower body mass index (P = 0.09) as compared to GHD patients (n = 25). By definition, peak GH (microg/l) was higher in GHS patients [15.0 +/- 1.8 vs. 1.0 +/- 0.2 (P < 0.0001)]. The increase in serum cortisol during the ITT (insulin-tolerance test) was higher and occurred later in GHS patients [Cmax (nmol/l): 561 +/- 41 vs. 412 +/- 50 (P = 0.04); Tmax (minutes): 65 +/- 5 vs. 49 +/- 5 (P = 0.03)]. Serum ghrelin levels changed significantly with time during ITT in both groups (P < 0.0001), characterized by a moderate decline during the initial 50-60 min and a return to baseline after 2 h. No significant differences were recorded in AUCghrelin during the ITT between the two groups. No gender differences in ghrelin levels were recorded. CONCLUSIONS: (i) Like in healthy subjects serum ghrelin levels are suppressed during an ITT in patients with suspected hypopituitarism. (ii) The suppression of ghrelin was similar in GHD and GHS subjects and was not determined by cortisol. (iii) We hypothesize that insulin rather than hypoglycaemia accounts for ghrelin suppression during an ITT. SN - 0300-0664 UR - https://www.unboundmedicine.com/medline/citation/16886962/Serum_ghrelin_levels_are_suppressed_in_hypopituitary_patients_following_insulin_induced_hypoglycaemia_irrespective_of_GH_status_ L2 - https://doi.org/10.1111/j.1365-2265.2006.02575.x DB - PRIME DP - Unbound Medicine ER -