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Ghrelin and Obestatin Levels in Children With Failure to Thrive and Obesity

Wali, Prateek*; King, Jeremy*; He, Zhaoping; Tonb, Dalal; Horvath, Karoly*

Journal of Pediatric Gastroenterology & Nutrition:
doi: 10.1097/MPG.0000000000000223
Original Articles: Hepatology and Nutrition

Objectives: Ghrelin and obestatin are 2 gastric hormones with opposite effects on food intake and body weight. We investigated plasma ghrelin and obestatin in children with failure to thrive (FTT) and obesity as compared with age-matched controls.

Methods: A total of 63 children were included in the study: 13 with FTT, 17 with obesity, and 33 age-matched controls. Children fasted for at least 8 hours before specimen collection. Both hormones were measured using commercially available enzyme immunoassay kits.

Results: Ghrelin and obestatin levels in children with FTT were not significantly different from that of the age-matched controls (P >0.05). In children with obesity, the total ghrelin levels were significantly lower (P = 0.0003) and the obestatin levels significantly higher (P = 0.029) compared with those in controls. In the control group, the fasting ghrelin level was significantly higher in the younger (<3 years) than in the older children (>3 years; P = 0.0004). Obestatin levels correlated positively with weight-for-age percentiles in the obese group (P = 0.011) and negatively in the control group >3 years (P = 0.019).

Conclusions: Compared with the levels in age-matched controls, fasting ghrelin and obestatin levels did not differ significantly in children with FTT. In the children with obesity, the decreased ghrelin and increased obestatin levels suggest a possible adaptive process to positive energy balance. Ghrelin had pronounced age-related changes, and obestatin was associated with the weight status. This may suggest that these 2 hormones use different mechanisms to regulate energy balance and weight.

Author Information

*Division of Gastroenterology and Nutrition

Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE.

Address correspondence and reprint requests to Zhaoping He, PhD, Nemours Biomedical Research, Nemours/Alfred I. duPont Hospital for Children, PO Box 269, Wilmington, DE 19803 (e-mail:

Received 1 January, 2013

Accepted 17 October, 2013

The authors report no conflicts of interest.

© 2014 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,