Ghrelin and Peptide YY Change During Puberty: Relationships With Adolescent Growth, Development, and Obesity
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
Authors: Cheng, Hoi Lun; Sainsbury, Amanda; Garden, Frances; Sritharan, Myuran; Paxton, Karen; Luscombe, Georgina; Hawke, Catherine; Steinbeck, Katharine
Abstract
Context: Pubertal adolescents show strong appetites. How this is mediated is unclear, but ghrelin and peptide YY (PYY) play potentially important roles. Objective: To measure ghrelin and PYY change in relation to pubertal growth. Design: Three-year prospective cohort study. Setting: Australian regional community. Participants: Eighty healthy adolescents (26 girls; 54 boys) recruited at 10 to 13 years. Main Outcome Measures: Fasting circulating total ghrelin, total PYY, IGF-1, insulin, leptin (via radioimmunoassay), estradiol and testosterone (via mass spectrometry), anthropometry, and body composition (via bioelectrical impedance). Results: Adolescents exhibited normal developmental change. Mixed models revealed positive associations for ghrelin to age2 (both sexes: P < 0.05), indicating a U-shaped trend over time. Ghrelin was also inversely associated with IGF-1 (both sexes: P < 0.05), leptin in girls (P < 0.01), and insulin in boys (P < 0.05) and negatively correlated with annual height and weight velocity (both sexes: P <= 0.01). PYY showed no age-related change in either sex. Neither ghrelin nor PYY were associated with Tanner stage. Weight subgroup analyses showed significant ghrelin associations with age2 in healthy-weight but not overweight and obese adolescents (7 girls; 18 boys). Conclusions: Adolescents showed a U-shaped change in ghrelin corresponding to physical and biochemical markers of growth, and no change in PYY. The overweight and obesity subgroup exhibited an apparent loss of the U-shaped ghrelin trend, but this finding may be attributed to greater maturity and its clinical significance is unclear. Further research on weight-related ghrelin and PYY trends at puberty is needed to understand how these peptides influence growth and longterm metabolic risk.
Endoscopic Bariatric and Metabolic Therapies: Surgical Analogues and Mechanisms of Action
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY
Authors: Jirapinyo, Pichamol; Thompson, Christopher C.
Abstract
Obesity is a worsening pandemic with numerous related comorbid illnesses. Conservative management including lifestyle modification and medications have limited efficacy. In contradistinction, bariatric surgery is effective, however, with substantial cost and non-negligible morbidity and mortality. As such, a small percentage of eligible patients undergo surgery. Over the past decade, endoscopic bariatric and metabolic therapies have been introduced as a less invasive option for the treatment of obesity and its related comorbid illnesses. This article reviews major endoscopic bariatric and metabolic therapies, their surgical analogues, and proposed mechanisms of action. Clinical trial data for each device also are discussed.