Division of Pediatrics, Department of Health Sciences (F.P., A.M., R.R., A.M., S.B., M.R., G.B.); Endocrinology, Department of Translational Medicine (F.P., G.A.); and Interdisciplinary Center for Obesity Study (F.P., S.B., G.B.), Università del Piemonte Orientale "A. Avogadro," Novara, 28100, Italy.
J Clin Endocrinol Metab. 2014 May;99(5):1556-68. doi: 10.1210/jc.2013-4010. Epub 2014 Mar 6.
Food intake and energy balance are regulated during the lifespan with critical changes in each specific period (infancy, adulthood, aging). Some of ghrelin's changes may contribute to the regulation of food intake and weight in children. We aimed to analyze the ghrelin response to feeding in lean or obese subjects from birth to adolescence.
We searched PubMed, Scopus, Google Scholar, Cochrane, and EMBASE (December 1999 to February 2013) and identified 62 relevant articles, of which 29 were suitable to be included.
Total ghrelin response to meals is particular, with refractoriness in neonates and lean children and an inhibition that starts from puberty. Total ghrelin levels are decreased after meals, irrespective of pubertal stages in obese children and adolescents. Conversely, total ghrelin is decreased after an oral glucose tolerance test in all ages, with the exception of neonates. Data on unacylated ghrelin response are scant but resemble those of total ghrelin. The acylated ghrelin response to meals or oral glucose tolerance test is discordant, although a precocious inhibition followed by a rise back is present in both lean and obese children. The post-feeding profile in children with Prader-Willi syndrome is also peculiar, with a conserved and deeper inhibition of all ghrelin forms.
食物摄入和能量平衡在整个生命周期中受到调节，每个特定阶段（婴儿期、成年期、老年期）都会发生重大变化。Ghrelin 的一些变化可能有助于调节儿童的食物摄入和体重。我们旨在分析从出生到青春期瘦素或肥胖受试者的进食对 ghrelin 的反应。
我们在 PubMed、Scopus、Google Scholar、Cochrane 和 EMBASE（1999 年 12 月至 2013 年 2 月）上进行了检索，并确定了 62 篇相关文章，其中 29 篇适合纳入。
总的 ghrelin 对膳食的反应是特殊的，新生儿和瘦儿童对其有抵抗作用，青春期开始时则受到抑制。肥胖儿童和青少年无论处于青春期哪个阶段，餐后总 ghrelin 水平均下降。相反，所有年龄段的口服葡萄糖耐量试验后，总 ghrelin 水平均下降，新生儿除外。未酰化 ghrelin 反应的数据很少，但与总 ghrelin 相似。膳食或口服葡萄糖耐量试验对酰化 ghrelin 的反应不一致，但在瘦素和肥胖儿童中均存在先抑制后回升的现象。Prader-Willi 综合征患儿的餐后特征也很特殊，所有 ghrelin 形式的抑制均保持不变且更为深入。
