Implications of gastrointestinal hormones in the pathogenesis of obesity in prepubertal children

J Pediatr Endocrinol Metab. 2012;25(3-4):255-60. doi: 10.1515/jpem-2011-0478.

Abstract

Background: There is a worsening high prevalence of global obesity. Special attention has been paid to the gut-endocrine system, represented by the regulators of appetite. In particular, it has been suggested that ghrelin ("hunger" peptide), and obestatin and glucagon-like peptide-1 (GLP-1) ("satiety" peptides) could play important roles in the pathogenesis of obesity.

Objectives: The aims of this study were to compare fasting plasma ghrelin, obestatin, and GLP-1 levels between obese and nonobese prepubertal children, and to assess their relations with fatness indexes and insulin resistance (IR).

Subjects and methods: Fifty-two prepubertal obese children and 22 controls were enrolled. Fasting levels of gastrointestinal hormones (ghrelin, obestatin, and GLP-1), glucose, and insulin were evaluated. IR was assessed using the homeostasis model assessment of IR (HOMA-IR) index. Analysis was performed by Mann-Whitney U-test, Kruskal-Wallis test, and Spearman's correlation.

Results: Obese prepubertal children and normal-weight controls had similar age distribution. Obese children were more insulin resistant when compared to controls (HOMA-IR: p < 0.01 ). GLP-1 levels were significantly lower in obese children than in controls (p < 0.01). Obestatin was significantly higher in obese than normal-weight children (p < 0.01), while ghrelin was not different. There was a negative correlation between GLP-1 and standard deviation score-body mass index (r = -0.36, p = 0.009) and between GLP-1 and waist circumference (r = -0.45, p = 0.001), while no association was observed with HOMA-IR.

Conclusions: GLP-1 levels have been shown to be correlated with adiposity indexes, but not with HOMA-IR, suggesting that this hormone could play an important role in the early development of obesity.

Publication types

  • Comparative Study

MeSH terms

  • Adiposity
  • Blood Glucose / analysis
  • Body Mass Index
  • Case-Control Studies
  • Child
  • Female
  • Gastrointestinal Hormones / adverse effects*
  • Ghrelin / adverse effects
  • Glucagon-Like Peptide 1 / adverse effects
  • Humans
  • Incretins / adverse effects
  • Insulin / blood
  • Insulin Resistance*
  • Leptin / blood
  • Male
  • Obesity / etiology*
  • Obesity / pathology*
  • Waist Circumference

Substances

  • Blood Glucose
  • Gastrointestinal Hormones
  • Ghrelin
  • Incretins
  • Insulin
  • Leptin
  • obestatin, human
  • Glucagon-Like Peptide 1