期刊名称：Egyptian Journal of Pediatric Allergy and Immunology
印刷版ISSN：1687-1642
电子版ISSN：2314-8934
出版年度：2011
卷号：9
期号：2
页码：63-70
出版社：Egyptian Society of Pediatric Allergy and Immunology
摘要：Type-1 diabetes mellitus(T1DM) is the commonestendocrine-metabolic disease in childhood. Ghrelin is a 28-amino-acidpeptide hormone secreted predominantly by P/D1 cells lining the fundusof the stomach and epsilon cells of the pancreas that stimulates appetitewith lesser amounts secreted by other cells. It is not clear which factorsare involved in the regulation of ghrelin secretion in children withT1DM. Objective: This study aimed to estimate the level of pre-prandialplasma ghrelin level in children with T1DM and to clarify therelationship between its level and some parameters that may affect it asBMI, serum glucose and HbA1C levels and the effect of insulin therapyon its level. Methods: This study included 88 children, 66 diabeticchildren with type-1 diabetes mellitus(22 new-onset diagnosed diabeticchildren, 22 good glycemic controlled diabetic children on regularinsulin therapy and 22 poor glycemic controlled diabetic children oninsulin therapy) and 22 healthy controls. Diabetic children selectedfrom the Diabetic Clinic and Inpatient Pediatric department, MiniaUniversity hospital from April 2009 to March 2010. Their ages rangedfrom 4 to 10 years with a mean 8.5 ± 1.53 years. All children weresubjected to history taking, clinical examination, anthropometricmeasurements and laboratory investigations included: Fasting and twohours post-prandial blood glucose, HbA1C , liver and renal functiontests and pre-prandial plasma ghrelin level using enzyme linkedimmunosorbant assay (ELISA). Results: Pre-prandial plasma ghrelinlevels were significantly higher in diabetic children thancontrols(24.4±21.4 & 9.8±3.6 pg/ml respectively, p value=0.002).Bothnew-onset and poorly controlled diabetic groups were significantlyhigher in plasma ghrelin levels (37.03±24.2 & 25.1±19.5 pg/ml, pvalue=0.001 & 0.001 respectively),but no significant difference betweengood glycemic controlled diabetic group and controls(11.09±9.6 &9.8±3.6 pg/ml respectively, p value=0.5). Significant negativecorrelations were found between ghrelin level and weight , weight oncentile, BMI and BMI on centile, ,fasting and 2 hours post prandialglucose levels in all diabetic children. No significant difference betweenmales and females as regards ghrelin level was present. Conclusions:Children with T1DM had significantly higher levels of pre-prandialplasma ghrelin level. Its level increased in both of new-onset andpoorly controlled diabetic children. Significant negative correlationsbetween pre-prandial ghrelin level and weight, BMI, fasting and 2-hours post-prandial levels were present. Insulin therapy plays animportant role in normalizing plasma ghrelin level in good glycemiccontrolled T1DM children. No significant correlation between ghrelinand HbA1C was present.
