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Somatostatin infusion lowers plasma ghrelin withoug reducing appetite in adults with Pradi-Willi syndrome

Tan, TMM; Vanderpump, M; Khoo, B; Patterson, M; Ghatei, MA; Goldstone, AP; (2004) Somatostatin infusion lowers plasma ghrelin withoug reducing appetite in adults with Pradi-Willi syndrome. J CLIN ENDOCR METAB , 89 (8) 4162 - 4165. 10.1210/jc.2004-0835. Green open access

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Abstract

Prader-Willi syndrome (PWS) is characterized by life-threatening childhood-onset hyperphagia, obesity and, uniquely, high plasma levels of ghrelin, the orexigenic gastric hormone. Somatostatin suppresses ghrelin secretion in normal subjects. We therefore examined the effect of somatostatin on plasma ghrelin and appetite in four male PWS adults fasted overnight in a double-blind, placebo-controlled, randomized cross-over study. Subjects received an intravenous infusion of somatostatin (250 mug/hr) or saline for 300min, and had blood samples taken every 30min for measurement of plasma ghrelin and PYY3-36 (anorexigenic intestinal hormone) by radio-immunoassay, and glucose. Appetite was measured by counting sandwiches eaten over a 60min free food access period from +120min. Despite somatostatin lowering fasting plasma ghrelin by 60 +/- 2% (P = 0.04) to levels seen in non-PWS men, there was no associated reduction in food intake (105 +/- 9% of food intake during saline infusion, P = 0.6). Somatostatin also lowered plasma PYY levels by 45 +/- 16% (P = 0.04), and produced post-prandial hyperglycemia (P = 0.04). We conclude that either hyperghrelinemia may not contribute to hyperphagia in PWS adults, or perhaps concomitant reductions in anorexigenic gastrointestinal hormones by somatostatin counteracted any anorexigenic effect of lowering orexigenic ghrelin. Somatostatin analogues may therefore not be an effective therapy for obesity in PWS. Larger chronic studies with long-acting somatostatin analogues will be needed to determine their benefits and risks in treating PWS obesity.

Type: Article
Title: Somatostatin infusion lowers plasma ghrelin withoug reducing appetite in adults with Pradi-Willi syndrome
Open access status: An open access version is available from UCL Discovery
DOI: 10.1210/jc.2004-0835
Publisher version: http://dx.doi.org/10.1210/jc.2004-0835
Language: English
Additional information: Copyright © 2004 by The Endocrine Society
Keywords: FOOD-INTAKE, CIRCULATING GHRELIN, OCTREOTIDE THERAPY, OBESE SUBJECTS, HUMANS, INSULIN, SUPPRESSES, CHILDREN, ADIPOSITY, SATIETY
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Renal Medicine
URI: https://discovery.ucl.ac.uk/id/eprint/146543
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