Abstract

Obesity beginning in childhood often leads to hyperinsulinemic state. Ghrelin, a recently discovered growth hormone (GH) secretagogue with orexigenic effects, is proposed to be a regulator of energy balance. It is thought to be associated with obesity and metabolic syndrome. Increased abdominal fat may lead to the development of metabolic syndrome in children and has been strongly associated with insulin resistance. The aims of this study were to determine fasting ghrelin levels of obese children of diabetic parents and obese children of non-diabetic parents and to investigate possible correlations between ghrelin hormones with insulin levels. This was a cross sectional study. Eighty obese children ranging from 5 to 18 years of age were recruited from the Pediatric Clinic of Shalamar Hospital, Lahore. These children were divided in two groups. Group A consists of forty obese children of diabetic parents and Group B having forty obese children of non-diabetic parents. A significant increase in the mean level of insulin, insulin resistance, triglycerides and fasting blood glucose were observed with concomitant significant decrease in the mean level of ghrelin. Fasting ghrelin levels were negatively correlated with insulin, homeostatic model assessment-insulin resistance (HOMA-IR), body mass index (BMI) and waist circumference. The results suggest that the down regulation of ghrelin secretion may be a consequence of higher insulin resistance associated with visceral fat accumulation.  Ghrelin might prove to be a useful tool to identify obese children at risk for developing insulin resistance, diabetes or metabolic syndrome.

Key words: Ghrelin, obesity, insulin resistance, metabolic syndrome.