Serum ghrelin in infants with protein-energy malnutrition

Background: Ghrelin is an appetite and weight physiologic controller. The question is whether there is a relation between ghrelin and protein-energy malnutrition (PEM). Our aim was to assess serum ghrelin in these patients and its relation to different patient variables. Methods: A cross-sectional study was conducted on 30 PEM infants (12 marasmic = Ia, 10 kwashiorkor = Ib and 8 marasmic kwashiorkor = Ic) and 15 age and sex matched controls (II). Plasma ghrelin was measured in all subjects using radioimmunoassay with thorough medical history and clinical assessment. Results: The mean serum ghrelin levels were significantly higher among the 3 patient Subgroups than controls with no significant inter-subgroup differences. The presence of intestinal parasitic infestations or edema, type of milk feeding and gender had no significant effects on serum ghrelin levels. Conclusion: Serum ghrelin is elevated in PEM as an adapting consequence of the malnutrition rather than a primary event. Although this elevation may not be helpful to correct the growth failure because of deficient nutrients, it may prove to have a role in the catch up phenomenon after the recovery. Further research should be directed toward therapeutic trials of ghrelin in the recovery phase. (C) 2009 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.