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This Article Accepted manuscript (PDF) All Versions of this Article: EJE-08-0357v1 159/5/555    most recent Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Darendeliler, F. Articles by Can, G. PubMed PubMed Citation Articles by Darendeliler, F., Professor Articles by Can, G.

Elevated Ghrelin Levels in Preterm Born Children During Prepubertal Ages and Relationship with Catch up Growth

F Darendeliler, Department of Pediatrics, Pediatric Endocrinology Unit, Istanbul University, Istanbul Faculty of Medicine, Istanbul, 34390, Turkey
F Bas, Department of Pediatrics, Pediatric Endocrinology Unit, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
R Bundak, Department of Pediatrics, Pediatric Endocrinology Unit, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
A Coban, Department of Pediatrics, Neonatalogy Unit, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
R Disci, Department of Biostatistics, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
O Sancakli, Department of Pediatrics, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
G Gokcay, Department of Pediatrics, Social Pediatrics Unit, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
Z Ince, Department of Pediatrics, Neonatalogy Unit, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
G Can, Department of Pediatrics, Neonatalogy Unit, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey

Correspondence: Feyza Darendeliler, Email: feyzad{at}istanbul.edu.tr

Abstract

Background:Ghrelin, the natural ligand of the growth hormone(GH) secretagogue receptor, has potent orexigenic effect. Ghrelin levels are negatively associated with insulin secretion; increased in anorexia and reduced in obesity. Increased ghrelin levels may be associated with early postnatal growth in preterm born children.Objective:Aim of this study was to evaluate ghrelin and insulin levels in preterm born children born appropriate for gestational age(AGA) or small for gestational age(SGA) and relations with catch up growth(CUG) in a prospective, cross-sectional study.Methods:84 preterm born children grouped as pretermSGA(n=28)and pretermAGA(n=56)were evaluated at age 4.7±0.2 and4.7±0.1years with respect to their ghrelin and insulin levels.Their data were compared to that of bodymassindex(BMI)matched termSGA(n=35)and termAGA(n=44)children of age 4.6±0.2and3.8±0.1years. All children had height appropriate for their target height.CUG was defined as the difference between birth size and recent size and expressed as height and weightSDS.Results:PretermSGAand pretermAGA children had similar ghrelin levels(1717.0±166.9pg/ml and 1656.5±103.8pg/ml)although height andweightSDS in pretermSGA were significantly higher than in pretermAGA children(p<0.001).Ghrelin levels in both preterm groups were higher than in termSGA(469.2±132.5pg/ml)and in termAGA children(659.6±143.3pg/ml)(p<0.001 for all).height and weightSDS of the termSGAchildren were similar to that of pretermSGA children.Ghrelin did not have correlation with CUG but had inverse correlation with recent anthropometric indices. Insulin was significantly higher in termSGA children than in other groups(p<0.001).Conclusions:Preterm children have higher ghrelin levels at prepubertal ages regardless of the magnitude of theirCUG.TermSGA children, on the other hand, behave differently and have lower ghrelin levels than preterm children at prepubertal ages which may be related to elevated insulin levels in this group.