Macronutrient regulation of ghrelin and peptide YY in pediatric obesity and prader-willi syndrome

Pinar Gumus Balikcioglu, Metin Balikcioglu, Michael J. Muehlbauer, Jonathan Purnell, David Broadhurst, Michael Freemark, Andrea M. Haqq

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background: The roles of macronutrients and GH in the regulation of food intake in pediatric obesity and Prader-Willi Syndrome (PWS) are poorly understood. Objective:Wecompared effects of high-carbohydrate (HC) and high-fat (HF) meals andGHtherapy on ghrelin, insulin, peptide YY (PYY), and insulin sensitivity in children with PWS and body mass index (BMI)-matched obese controls (OCs). Methods: In a randomized, crossover study, 14 PWS (median, 11.35 y; BMI z score [BMI-z], 2.15) and 14 OCs (median, 11.97 y; BMI-z, 2.35) received isocaloric breakfast meals (HC or HF) on separate days. Blood samples were drawn at baseline and every 30 minutes for 4 hours. Mixed linear models were adjusted for age, sex, and BMI-z. Results: Relative to OCs, children withPWShad lower fasting insulin and higher fasting ghrelin and ghrelin/PYY. Ghrelin levels were higher in PWS across all postprandial time points (P = .0001). Carbohydrate was more potent than fat in suppressing ghrelin levels in PWS (P <.028); HC and HF were equipotent in OCs but less potent than in PWS (P <.011). The increase in PYY following HF was attenuated in PWS (P <.037); thus, postprandial ghrelin/PYY remained higher throughout. A lesser increase in insulin and lesser decrease in ghrelin were observed in GH-treated PWS patients than in untreated patients; PYY responses were comparable. Conclusion: Children withPWShave fastingandpostprandial hyperghrelinemiaandanattenuated PYY response to fat, yielding a high ghrelin/PYY ratio. GH therapy in PWS is associated with increased insulin sensitivity and lesser postprandial suppression of ghrelin. The ratio Ghrelin/PYY may be a novel marker of orexigenic drive.

Original languageEnglish (US)
Pages (from-to)3822-3831
Number of pages10
JournalJournal of Clinical Endocrinology and Metabolism
Volume100
Issue number10
DOIs
StatePublished - Oct 1 2015

Fingerprint

Peptide YY
Prader-Willi Syndrome
Pediatrics
Ghrelin
Pediatric Obesity
Fats
Insulin
Body Mass Index
Carbohydrates
Meals
Insulin Resistance
Fasting
Appetite Regulation
Breakfast
Cross-Over Studies
Linear Models
Blood

ASJC Scopus subject areas

  • Biochemistry
  • Clinical Biochemistry
  • Endocrinology
  • Biochemistry, medical
  • Endocrinology, Diabetes and Metabolism

Cite this

Balikcioglu, P. G., Balikcioglu, M., Muehlbauer, M. J., Purnell, J., Broadhurst, D., Freemark, M., & Haqq, A. M. (2015). Macronutrient regulation of ghrelin and peptide YY in pediatric obesity and prader-willi syndrome. Journal of Clinical Endocrinology and Metabolism, 100(10), 3822-3831. https://doi.org/10.1210/jc.2015-2503

Macronutrient regulation of ghrelin and peptide YY in pediatric obesity and prader-willi syndrome. / Balikcioglu, Pinar Gumus; Balikcioglu, Metin; Muehlbauer, Michael J.; Purnell, Jonathan; Broadhurst, David; Freemark, Michael; Haqq, Andrea M.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 100, No. 10, 01.10.2015, p. 3822-3831.

Research output: Contribution to journalArticle

Balikcioglu, PG, Balikcioglu, M, Muehlbauer, MJ, Purnell, J, Broadhurst, D, Freemark, M & Haqq, AM 2015, 'Macronutrient regulation of ghrelin and peptide YY in pediatric obesity and prader-willi syndrome', Journal of Clinical Endocrinology and Metabolism, vol. 100, no. 10, pp. 3822-3831. https://doi.org/10.1210/jc.2015-2503
Balikcioglu, Pinar Gumus ; Balikcioglu, Metin ; Muehlbauer, Michael J. ; Purnell, Jonathan ; Broadhurst, David ; Freemark, Michael ; Haqq, Andrea M. / Macronutrient regulation of ghrelin and peptide YY in pediatric obesity and prader-willi syndrome. In: Journal of Clinical Endocrinology and Metabolism. 2015 ; Vol. 100, No. 10. pp. 3822-3831.
@article{934f1f11359b4ca68f517b87550b2ecc,
title = "Macronutrient regulation of ghrelin and peptide YY in pediatric obesity and prader-willi syndrome",
abstract = "Background: The roles of macronutrients and GH in the regulation of food intake in pediatric obesity and Prader-Willi Syndrome (PWS) are poorly understood. Objective:Wecompared effects of high-carbohydrate (HC) and high-fat (HF) meals andGHtherapy on ghrelin, insulin, peptide YY (PYY), and insulin sensitivity in children with PWS and body mass index (BMI)-matched obese controls (OCs). Methods: In a randomized, crossover study, 14 PWS (median, 11.35 y; BMI z score [BMI-z], 2.15) and 14 OCs (median, 11.97 y; BMI-z, 2.35) received isocaloric breakfast meals (HC or HF) on separate days. Blood samples were drawn at baseline and every 30 minutes for 4 hours. Mixed linear models were adjusted for age, sex, and BMI-z. Results: Relative to OCs, children withPWShad lower fasting insulin and higher fasting ghrelin and ghrelin/PYY. Ghrelin levels were higher in PWS across all postprandial time points (P = .0001). Carbohydrate was more potent than fat in suppressing ghrelin levels in PWS (P <.028); HC and HF were equipotent in OCs but less potent than in PWS (P <.011). The increase in PYY following HF was attenuated in PWS (P <.037); thus, postprandial ghrelin/PYY remained higher throughout. A lesser increase in insulin and lesser decrease in ghrelin were observed in GH-treated PWS patients than in untreated patients; PYY responses were comparable. Conclusion: Children withPWShave fastingandpostprandial hyperghrelinemiaandanattenuated PYY response to fat, yielding a high ghrelin/PYY ratio. GH therapy in PWS is associated with increased insulin sensitivity and lesser postprandial suppression of ghrelin. The ratio Ghrelin/PYY may be a novel marker of orexigenic drive.",
author = "Balikcioglu, {Pinar Gumus} and Metin Balikcioglu and Muehlbauer, {Michael J.} and Jonathan Purnell and David Broadhurst and Michael Freemark and Haqq, {Andrea M.}",
year = "2015",
month = "10",
day = "1",
doi = "10.1210/jc.2015-2503",
language = "English (US)",
volume = "100",
pages = "3822--3831",
journal = "Journal of Clinical Endocrinology and Metabolism",
issn = "0021-972X",
publisher = "The Endocrine Society",
number = "10",

}

TY - JOUR

T1 - Macronutrient regulation of ghrelin and peptide YY in pediatric obesity and prader-willi syndrome

AU - Balikcioglu, Pinar Gumus

AU - Balikcioglu, Metin

AU - Muehlbauer, Michael J.

AU - Purnell, Jonathan

AU - Broadhurst, David

AU - Freemark, Michael

AU - Haqq, Andrea M.

PY - 2015/10/1

Y1 - 2015/10/1

N2 - Background: The roles of macronutrients and GH in the regulation of food intake in pediatric obesity and Prader-Willi Syndrome (PWS) are poorly understood. Objective:Wecompared effects of high-carbohydrate (HC) and high-fat (HF) meals andGHtherapy on ghrelin, insulin, peptide YY (PYY), and insulin sensitivity in children with PWS and body mass index (BMI)-matched obese controls (OCs). Methods: In a randomized, crossover study, 14 PWS (median, 11.35 y; BMI z score [BMI-z], 2.15) and 14 OCs (median, 11.97 y; BMI-z, 2.35) received isocaloric breakfast meals (HC or HF) on separate days. Blood samples were drawn at baseline and every 30 minutes for 4 hours. Mixed linear models were adjusted for age, sex, and BMI-z. Results: Relative to OCs, children withPWShad lower fasting insulin and higher fasting ghrelin and ghrelin/PYY. Ghrelin levels were higher in PWS across all postprandial time points (P = .0001). Carbohydrate was more potent than fat in suppressing ghrelin levels in PWS (P <.028); HC and HF were equipotent in OCs but less potent than in PWS (P <.011). The increase in PYY following HF was attenuated in PWS (P <.037); thus, postprandial ghrelin/PYY remained higher throughout. A lesser increase in insulin and lesser decrease in ghrelin were observed in GH-treated PWS patients than in untreated patients; PYY responses were comparable. Conclusion: Children withPWShave fastingandpostprandial hyperghrelinemiaandanattenuated PYY response to fat, yielding a high ghrelin/PYY ratio. GH therapy in PWS is associated with increased insulin sensitivity and lesser postprandial suppression of ghrelin. The ratio Ghrelin/PYY may be a novel marker of orexigenic drive.

AB - Background: The roles of macronutrients and GH in the regulation of food intake in pediatric obesity and Prader-Willi Syndrome (PWS) are poorly understood. Objective:Wecompared effects of high-carbohydrate (HC) and high-fat (HF) meals andGHtherapy on ghrelin, insulin, peptide YY (PYY), and insulin sensitivity in children with PWS and body mass index (BMI)-matched obese controls (OCs). Methods: In a randomized, crossover study, 14 PWS (median, 11.35 y; BMI z score [BMI-z], 2.15) and 14 OCs (median, 11.97 y; BMI-z, 2.35) received isocaloric breakfast meals (HC or HF) on separate days. Blood samples were drawn at baseline and every 30 minutes for 4 hours. Mixed linear models were adjusted for age, sex, and BMI-z. Results: Relative to OCs, children withPWShad lower fasting insulin and higher fasting ghrelin and ghrelin/PYY. Ghrelin levels were higher in PWS across all postprandial time points (P = .0001). Carbohydrate was more potent than fat in suppressing ghrelin levels in PWS (P <.028); HC and HF were equipotent in OCs but less potent than in PWS (P <.011). The increase in PYY following HF was attenuated in PWS (P <.037); thus, postprandial ghrelin/PYY remained higher throughout. A lesser increase in insulin and lesser decrease in ghrelin were observed in GH-treated PWS patients than in untreated patients; PYY responses were comparable. Conclusion: Children withPWShave fastingandpostprandial hyperghrelinemiaandanattenuated PYY response to fat, yielding a high ghrelin/PYY ratio. GH therapy in PWS is associated with increased insulin sensitivity and lesser postprandial suppression of ghrelin. The ratio Ghrelin/PYY may be a novel marker of orexigenic drive.

UR - http://www.scopus.com/inward/record.url?scp=84943808229&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84943808229&partnerID=8YFLogxK

U2 - 10.1210/jc.2015-2503

DO - 10.1210/jc.2015-2503

M3 - Article

C2 - 26259133

AN - SCOPUS:84943808229

VL - 100

SP - 3822

EP - 3831

JO - Journal of Clinical Endocrinology and Metabolism

JF - Journal of Clinical Endocrinology and Metabolism

SN - 0021-972X

IS - 10

ER -