Ghrelin, leptin and insulin levels in underweight children

Undernutrition due to poor or selective eating is the main factor leading to underweight in children. Various hormones of the gastrointestinal tract and adipose tissue are involved in the regulation of eating behavior. A significant role is played by ghrelin and leptin, which have opposite effects on appetite. Objective. To evaluate serum levels of ghrelin, leptin and insulin in underweight children to optimize management strategies. Patients and methods. A total of 143 patients aged between 1 year and 17 years 11 months were examined. All patients were divided into two groups: study group – 65 children with underweight (median age 9 [5; 13.5] years, 34 boys and 31 girls); control group – 78 children with normal weight (median age 11 [7; 13] years, 36 boys and 42 girls). Physical development was assessed according to the WHO criteria. The level of total ghrelin was studied in patients with underweight; acyl-ghrelin, leptin and insulin were studied in both groups. Results. With increasing age of patients, there was a tendency for total ghrelin levels to decrease and leptin and insulin levels to increase. In the general group of children with underweight, the levels of acyl-ghrelin, leptin and insulin were lower compared to the control group (p < 0.05). With increasing severity of undernutrition, total ghrelin increased, whereas acyl-ghrelin and leptin decreased. Girls had higher concentrations of leptin (2.6 [1.1;7.8] ng/mL), while boys had higher concentrations of total ghrelin and acyl-ghrelin (435.8 [235.6;605.3] and 25.9 [10.6;53.2] pg/mL, respectively). Total ghrelin levels were negatively correlated with age, leptin and insulin levels; acyl-ghrelin and leptin levels were positively correlated with BMI Z-score. Conclusion. Low levels of acyl-ghrelin, leptin and insulin were recorded in patients with underweight. Further research is needed to thoroughly understand the changes in hormonal status that occur in the body during the development of undernutrition. Key words: children, anthropometry, underweight, ghrelin, leptin, insulin