OBEZ ÇOCUKLARDAPLAZMAGHRELİN, SERUM IGF-I VE IGFBP-3 DÜZEYLERİ

Amaç: Günümüzde obesite bir çok metabolik ve hormonal bozukluğa sebep olan bir hastalık olarak kabul edilmektedir. Obez kişilerde kilo alımının nedenlerinin ve patofizyolojik sonuçlarının anlaşılması, obesiteyi önleyici etkintedavi ve korunma yöntemlerinin gelişmesine katkı sağlayabilir. Bu çalışmada, obez çocuklarda ghrelin düzeylerini ve büyüme faktörleri olan IGF-1 ve IGFBP-3 ile ilişkisini araştırdık. Gereç ve yöntem: 38 obez ve 19 sağlıklı çocuk çalışmaya dahil edilmiştir. Çalışmaya alınan olguların açlık ve tokluk ghrelin, IGF-I, IGFBP-3 düzeyleri ölçülmüştür.Bulgular: Normal çocuklara kıyasla, obez olguların plazma ghrelin düzeyleri düşük, IGF-I ve IGFBP–3 düzeyleri ise yüksek bulundu (p
Anahtar Kelimeler:

Obezite, ghrelin, IGF-I, IGFBP-3, çocuk

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  • Ariyasu H, Takaya K, Tagami T, Ogawa Y, Hosoda K, Aka- mizu T, Suda M, Koh T,Natsui K, Toyooka S, Shirakami G, Usui T, Shimatsu A, Doi K, Hosoda H, Kojima M, Kangawa K, Nakao K. Stomach is a major source of circulating ghre- lin, and feeding state determines plasma ghrelin-like immu- noreactivity levels in humans. J Clin Endocrinol Metab 2001; 86: 4753- 4758.
  • Bala RM, Lopatka J, Leung A, McCoy E, McArthur RG. Se- rum immunoreactive somatomedin levels in normal adults, pregnant women at term, children at various ages, and child- ren with constitutionally delayed growth. J Clin Endocrinol Metab 1981; 52: 508- 512.
  • Beckett PR, Wong WW, Copeland KC. Developmental changes in the relationship between IGF-I and body compo- sition during puberty. Growth Horm IGF Res 1998; 8: 283- 288.
  • Bellone S, Rapa A, Vivenza D, Castellino N, Petri A, Bello- ne J, Me E, Broglio F, Prodam F, Ghigo E, Bona G. Circula- ting ghrelin levels as function of gender, pubertal status and adiposity in childhood. J Endocrinol Invest 2002; 25: RC13- 15.
  • Bideci A, Cinaz P, Hasanoglu A, Elbeg S. Serum levels of in- sulin-like growth factor-I and insulin-like growth factor bin- ding protein-3 in obese children. J Pediatr Endocrinol Metab 1997; 10: 295- 299.
  • Blum WF, Albertsson-Wikland K, Rosberg S, Ranke MB. Serum levels of insulin-like growth factor I (IGF-I) and IGF binding protein 3 reflect spontaneous growth hormone sec- retion. J Clin Endocrinol Metab 1993; 76: 1610-1616.
  • Bundak R, Furman A, Gunoz H, Darendeliler F, Bas F, Ney- zi O. Body mass index references for Turkish children. Acta Paediatr 2006; 95: 194-198.
  • Edén Engström B, Burman P, Holdstock C, Karlsson FA. Ef- fects of growth hormone (GH) on ghrelin, leptin, and adipo- nectin in GH-deficient patients. J Clin Endocrinol Metab 2003; 88: 5193-5198.
  • Falorni A, Bini V, Cabiati G, Papi F, Arzano S, Celi F, Sana- si M. Serum levels of type I procollagen C-terminal propep- tide, insulin-like growth factor-I (IGF-I), and IGF binding protein-3 in obese children and adolescents: relationship to gender, pubertal development, growth, insulin, and nutriti- onal status. Metabolism 1997; 46: 862- 871.
  • Inui A, Asakawa A, Bowers CY, Mantovani G, Laviano A, Meguid MM, Fujimiya M. Ghrelin, appetite, and gastric mo- tility: the emerging role of the stomach as an endocrine or- gan. FASEB J 2004; 18: 439-456.
  • Kamegai J, Tamura H, Shimizu T, Ishii S, Sugihara H, Wa- kabayashi I. Chronic central infusion of ghrelin increases hypothalamic neuropeptide Y and Agouti-related protein mRNA levels and body weight in rats. Diabetes 2001; 50: 2438-2443.
  • Laron Z. IGF-1 and insulin as growth hormones. Novartis Found Symp 2004; 262: 56- 77.
  • Lengyel AM. Novel mechanisms of growth hormone regula- tion: growth hormone-releasing peptides and ghrelin. Braz J Med Biol Res 2006; 39: 1003-1011.
  • Loche S, Cappa M, Borrelli P, Faedda A, Crinò A, Cella SG, Corda R, Müller EE,Pintor C. Reduced growth hormone res- ponse to growth hormone-releasing hormone in children with simple obesity: evidence for somatomedin-C mediated inhibition. Clin Endocrinol (Oxf) 1987; 27: 145-153.
  • Neyzi O, Furman A, Bundak R, Gunoz H, Darendeliler F, Bas F. Growth references for Turkish children aged 6 to 18 years. Acta Paediatr 2006; 95: 1635- 1641.
  • Ranke MB, Blum WF, Bierich JR. Clinical relevance of se- rum measurements of insulin-like growth factors and soma- tomedin binding proteins. Acta Paediatr Scand Suppl 1988; 347: 114- 126.
  • Ranke MB, Elmlinger M. Functional role of insulin-like growth factor binding proteins. Horm Res 1997; 48: 9- 15.
  • Savastano S, Di Somma C, Belfiore A, Guida B, Orio F Jr, Rota F, Savanelli MC, Cascella T, Mentone A, Angrisani L, Lombardi G, Colao A. Growth hormone status in morbidly obese subjects and correlation with body composition. J En- docrinol Invest 2006; 29: 536-543.
  • Styne DM, Childhood and adolescent obesity. Prevalence and significance. Pediatr Clin North Am 2001; 48: 823- 854.
  • Tschöp M, Smiley DL, Heiman ML. Ghrelin induces adi- posity in rodents. Nature 2000; 407: 908- 913.
  • Tschöp M, Weyer C, Tataranni PA, Devanarayan V, Ravus- sin E, Heiman ML. Circulating ghrelin levels are decre- ased in human obesity. Diabetes 2001; 50: 707- 709.
  • Wilson DM, Stene MA, Killen JD, Hammer LD, Litt IF, Hayward C, Taylor CB. Insulin-like growth factor binding protein-3 in normal pubertal girls. Acta Endocrinol (Co- penh) 1992; 126: 381-386.
  • Wren AM, Seal LJ, Cohen MA, Brynes AE, Frost GS, Murphy KG, Dhillo WS, Ghatei MA, Bloom SR. Ghrelin enhances appetite and increases food intake in humans. J Clin Endocrinol Metab 2001; 86: 5992.
  • Wren AM, Small CJ, Abbott CR, Dhillo WS, Seal LJ, Co- hen MA, Batterham RL, Taheri S, Stanley SA, Ghatei MA, Bloom SR. Ghrelin causes hyperphagia and obesity in rats. Diabetes 2001; 50: 2540-2547.