# Effect of Oral Glucose Administration on Ghrelin Levels in Normal-Height Prepubertal Children Born Small for Gestational Age (SGA)

## TL;DR

This study found that ghrelin levels in children born small for gestational age are affected by obesity and insulin sensitivity, not just body fat.

## Contribution

The study reveals that ghrelin regulation in SGA children is more closely tied to insulin sensitivity than to adiposity.

## Key findings

- Ghrelin levels decreased significantly during the oral glucose tolerance test.
- Obese SGA children had lower ghrelin levels and a smaller decline compared to non-obese peers.
- Fasting ghrelin and its suppression were independently associated with insulin resistance.

## Abstract

Ghrelin is a regulator of appetite and growth hormone secretion, rising during fasting and decreasing after food intake. Children born small for gestational age (SGA) who undergo postnatal catch-up growth are at increased risk of obesity and metabolic disturbances, which may be related to impaired ghrelin regulation. This study assessed fasting and post-glucose ghrelin responses during an oral glucose tolerance test (OGTT) in prepubertal SGA children in relation to obesity and metabolic syndrome components. Ninety-eight children aged 5–9 years were included. Anthropometry, blood pressure, fasting lipids, glucose, insulin, and ghrelin were measured; BMI SDS and HOMA-IR were calculated. Ghrelin concentrations were assessed at baseline and 120 min after glucose ingestion. Ghrelin levels declined significantly during OGTT. Obese SGA children showed lower fasting and post-load ghrelin levels and a smaller decline compared with non-obese peers. Fasting and post-load ghrelin correlated inversely with BMI SDS, waist circumference, and insulin levels. In regression analyses, fasting ghrelin and its suppression were independently associated with HOMA-IR, whereas post-load ghrelin was determined by post-load insulin. These findings indicate that ghrelin dynamics in SGA children are more closely related to insulin sensitivity than adiposity and are blunted in the presence of obesity.