J Korean Med Sci.  2007 Jun;22(3):436-441. 10.3346/jkms.2007.22.3.436.

Peptide YY, Cholecystokinin, Insulin and Ghrelin Response to Meal did not Change, but Mean Serum Levels of Insulin is Reduced in Children with Prader-Willi Syndrome

• Paik KH
• Jin DK
• Lee KH
• Armstrong
• Lee JE
• Oh YJ
• Kim S
• Kwon EK
• Choe YH

• KMID: 1778350
• DOI: http://doi.org/10.3346/jkms.2007.22.3.436

Abstract

Prader-Willi syndrome (PWS) is a contiguous gene syndrome characterized by uncontrollable eating or hyperphagia. Several studies have confirmed that plasma ghrelin levels are markedly elevated in PWS adults and children. The study of anorexigenic hormones is of interest because of their regulation of appetite by negative signals. To study the pattern and response of the anorexigenic hormones such as cholecystokinin (CCK) and peptide YY (PYY) to a meal in PWS, we measured the plasma CCK, PYY, ghrelin and serum insulin levels in PWS patients (n=4) and in controls (n=4) hourly for a day, and analyzed hormone levels and hormonal responses to meals. Repeated measures of ANOVA of hormone levels demonstrated that only insulin levels decreased (p=0.013) and CCK (p=0.005) and ghrelin (p=0.0007) increased in PWS over 24 hr. However, no significant group x time interactions (ghrelin: p=0.89, CCK: p=0.93, PYY: p=0.68 and insulin: p=0.85) were observed; in addition, there were no differences in an assessment of a three-hour area under the curve after breakfast. These results suggest that the response pattern of hormones to meals in PWS patients parallels that of normal controls. In addition, the decrease of insulin levels over 24 hr, in spite of obesity and elevated ghrelin levels, suggests that the baseline insulin level, not the insulin response to meals, may be abnormal in patients with PWS.

Keyword

Ghrelin; Cholecystokinin; Peptide YY; Insulin; Prader-Willi Syndrome

MeSH Terms

Adolescent
Area Under Curve
Biopsy
Body Mass Index
Body Weight
Child
Cholecystokinin/*blood
Ghrelin
Humans
Insulin/*blood/metabolism
Male
Obesity
Peptide Hormones/*blood/metabolism
Peptide YY/*blood
Prader-Willi Syndrome/*blood
Time Factors

Figure

• 

  Fig. 1 24-hr mean plasma peptide YY (PYY) profiles (mean±SE) in Prader-Willi syndrome (PWS) (n=4) and sex- and age- matched controls (n=4). Hourly PYY values (0.46±0.01 ng/mL) were compared with those of controls 1-4 (0.48±0.01 ng/mL). PYY levels were not different over 24 hr, and PYY responses to meals were similar in the PWS and control groups (p=0.68). Arrows indicate meal times.

• 

  Fig. 2 24-hr mean plasma cholecystokinin (CCK) profiles (mean±SE) in Prader-Willi syndrome (PWS) (n=4) and in sex- and age-matched controls (n=4). The hourly CCK values of PWS patients (7.21±0.68 pg/mL) were compared with those of controls (4.16±0.35 pg/mL). These results indicate that mean CCK levels were elevated over 24 hr (p=0.0051), but the CCK response to meals was similar in the two groups (p=0.9311).

• 

  Fig. 3 24-hr mean plasma insulin profiles (mean±SE) in Prader-Willi syndrome (PWS) (n=4) and in sex- and age- matched controls (n=4). Hourly insulin values were compared between the two groups. Plasma insulin levels in the PWS group were lower (mean 29.19±3.23 µIU/mL) than in controls (mean 43.12±3.53 µIU/mL) throughout the 24-hr insulin monitoring period (p=0.01). However, insulin response to meals were similar in the two groups (p=0.85).

• 

  Fig. 4 24 hr mean plasma ghrelin profiles (mean±SE) in Prader-Willi syndrome (n=4) and in sex-age matched controls (n=4). Plasma ghrelin levels in the PWS group were higher (mean 5.61±0.5 µg/mL) than in controls (mean 2.08±0.13 ng/mL) (p<0.001) throughout the 24 hr monitoring period, but ghrelin suppression after meals was similar in the two groups (p=0.89).

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