Horm Metab Res 2018; 50(11): 822-826
DOI: 10.1055/a-0746-4014
Endocrine Care
© Georg Thieme Verlag KG Stuttgart · New York

Ghrelin Levels in Basal Conditions and During Glucose Tolerance Test in Prediabetic and Diabetic Patients

Ioannis Bounias
1   Medical School, Division of Endocrinology, Democritus University of Thrace, Alexandroupolis, Greece
,
Stamatia Pouliliou
2   Medical School, Department of Radiotherapy/Oncology, Democritus University of Thrace, Alexandroupolis, Greece
,
Gregory Tripsianis
3   Department of Medical Statistics, Democritus Univeristy of Thrace, Alexandroupolis, Greece
,
Cristos Antonoglou
4   Medical School, Second Department of Internal Medicine, Democritus University of Thrace, Alexandroupolis, Greece
,
Anna Papazoglou
4   Medical School, Second Department of Internal Medicine, Democritus University of Thrace, Alexandroupolis, Greece
,
Efstratios Maltezos
4   Medical School, Second Department of Internal Medicine, Democritus University of Thrace, Alexandroupolis, Greece
,
Dimitrios Papazoglou
4   Medical School, Second Department of Internal Medicine, Democritus University of Thrace, Alexandroupolis, Greece
› Author Affiliations
Further Information

Publication History

received 12 March 2018

accepted 11 September 2018

Publication Date:
04 October 2018 (online)

Abstract

Ghrelin is associated with glucose homeostasis but its’ possible relevance with glucose levels in physiological and pathological conditions has so far been poorly investigated. The aim of the present study was to evaluate circulating ghrelin levels in prediabetic and diabetic patients in basal conditions and in response to oral glucose tolerance test (OGTT). A total of 90 male adults aged 40 – 73 years old were enrolled in our study. Fasting and postprandial plasma ghrelin, insulin and glucose levels were measured at 0, 60, 120 and 180 min following an OGTT in 40 patients with type 2 diabetes mellitus (T2DM), 20 with impaired glucose tolerance (IGT) and 30 controls. Incremental and total area under response curve were determined and calculated for glucose, insulin and ghrelin. Fasting plasma ghrelin concentrations were significantly lower in the T2DM group than IGT and control group patients (p<0.01) but not between healthy subjects and IGT group (p=0.746). In the diabetics’ group ghrelin levels showed a statistically significant negative correlation with insulin and a positive correlation with HbA1c and glucose. At all time points after the OGTT ghrelin concentrations were significantly lower in the T2DM group compared to IGT group and controls. Plasma ghrelin concentrations are lower in male diabetic patients at the fasting state and remain lower at all time points after an OGTT while minor differences were found between normal and IGT subjects. Ghrelin might play a role in insulin and glucose metabolism in diabetic patients but not in patients with IGT.

 
  • References

  • 1 Kojima M, Hosoda H, Date Y, Nakazato M, Matsuo H, Kangawa K. Ghrelin is a growth-hormone-releasing acylated peptide stomach. Nature 1999; 402: 656-660
  • 2 Korbonits M, Goldstone AP, Gueorguiev M, Grossman AB. Ghrelin-A hormone with multiple functions. Front Neuroendocrinol 2004; 25: 27-68
  • 3 Pliquett RU, Führer D, Falk S, Zysset S, von Cramon DY, Stumvoll M. The effects of insulin on the central nervous system–focus on appetite regulation. Horm Metab Res 2006; 38: 442-446
  • 4 Nakazato M, Murakami N, Date Y, Kojima M, Matsuo H, Kangawa K, Matsukura S. A role for ghrelin in the central regulation of feeding. Nature 2001; 409: 194-198
  • 5 Tschöp M, Weyer C, Tataranni PA, Devanarayan V, Ravussin E, Heiman ML. Circulating ghrelin levels are decreased in human obesity. Diabetes 2001; 50: 707-709
  • 6 Pöykkö SM, Kellokoski E, Hörkkö S, Kauma H, Kesäniemi YA, Ukkola O. Low plasma ghrelin is associated with insulin resistance, hypertension and the prevalence of type 2 diabetes. Diabetes 2003; 52: 2546-2553
  • 7 Banks AK, Murphy KG. Role of ghrelin in glucose homeostasis and diabetes. Diabetes Manage 2013; 3: 171-182
  • 8 ADA (American Diabetes Association) position statement . Standards of medical care in diabetes – 2012. Diabetes Care 2012; 35 01 S11-S63
  • 9 Vodnik M, Štrukelj B, Lunder M. Ghrelin receptor ligands reaching clinical trials: from peptides to peptidomimetics; from agonists to antagonists hormone and metabolic research. Horm Metab Res 2016; 48: 1-15
  • 10 Krzyzanowska-Swiniarska B, Kempa A, Miazgowski T, Pilarska K. Serum acylated ghrelin, adiponectin and leptin levels in normal-weight and obese premenopausal women. Horm Metab Res 2007; 39: 835-839
  • 11 Kojima M, Kangawa K. Ghrelin- An orexigenic signaling molecule from the gastrointestinal tract. Curr Opin Pharmacol 2002; 2: 665-668
  • 12 Cowley MA, Smith RG, Diano S, Tschöp M, Pronchuk N, Grove KL, Strasburger CJ, Bidlingmaier M, Esterman M, Heiman ML, Garcia-Segura LM, Nillni EA, Mendez P, Low MJ, Sotonyi P, Friedman JM, Liu H, Pinto S, Colmers WF, Cone RD, Horvath TL. The distribution and mechanism of action of ghrelin in the CNS demonstrates a novel hypothalamic circuit regulating energy homeostasis. Neuron 2003; 37: 649-661
  • 13 Poher AL, Tschöp MH, Müller TD. Ghrelin regulation of glucose metabolism. Peptides 2018; 100: 236-242
  • 14 Hagemann D, Meier JJ, Gallwitz B, Schmidt WE. Appetite regulation by ghrelin – A novel neuro-endocrine gastric peptide hormone in the gut-brain-axis. Z Gastroenterol 2003; 41: 929-936
  • 15 Wiedmer P, Nogueiras R, Broglio F, D'Alessio D, Tschöp MH. Ghrelin, obesity and diabetes. Nat Clin Pract Endocrinol Metab 2007; 3: 705-712
  • 16 Barazzoni R, Zanetti M, Ferreira C, Vinci P, Pirulli A, Mucci M, Dore F, Fonda M, Ciocchi B, Cattin L, Guarnieri G. Relationships between desacylated and acylated ghrelin and insulin sensitivity in the metabolic syndrome. J Clin Endocrinol Metab 2007; 92: 3935-3940
  • 17 Ostergard T, Hansen TK, Nyholm B, Gravholt CH, Djurhuus CB, Hosoda H, Kangawa K, Schmitz O. Circulating ghrelin concentrations are reduced in healthy offspring of type 2 diabetic subjects, and are increased in women independent of a family history of type 2 diabetes. Diabetologia 2003; 46: 134-136
  • 18 Saad NF, Bernaba B, Hwu CM, Jinagouda S, Fahmi S, Kogosov E, Boyadjian R. Insulin regulates plasma ghrelin concentration. J Clin Endocrinol Metab 2002; 87: 3997-4000
  • 19 Riedl M, Maier C, Handisurya A, Luger A, Kautzky-Willer A. Insulin resistance has no impact on ghrelin suppresion in pregnancy. J Intern Med 2007; 262: 458-465
  • 20 Papaioannou I, Patterson M, Twigg GL, Vazir A, Ghatei M, Morrell MJ, Polkey MI. Lack of association between impaired glucose tolerance and appetite regulating hormones in patients with obstructive sleep apnea. J Clin Sleep Med 2011; 7: 486-492
  • 21 Chabot F, Caron A, Laplante M, St-Pierre DH. Interrelatiosnships between ghrelin, insulin and glucose homeostasis: Physiological relevance. World J Diabetes 2014; 5: 328-341
  • 22 Gröschl M, Uhr M, Kraus T. Evaluation of the comparability of commercial ghrelin assays. Clin Chem 2004; 50: 457-458