Administration of exogenous ghrelin in obese patients with polycystic ovary syndrome: effects on plasma levels of growth hormone, glucose, and insulin

ObjectiveTo assess the effects of the administration of exogenous ghrelin, a peptide with potent GH-releasing activity and glucose-enhancing and insulin-lowering properties, in obese patients with polycystic ovary syndrome (PCOS).DesignProspective, controlled study.SettingAcademic research environment.Patient(s)Twenty obese women with PCOS, and 15 obese controls.Intervention(s)Oral glucose tolerance test (OGTT) and ghrelin test (1 μg/kg IV bolus).Main Outcome Measure(s)Basal hormonal assays, including ghrelin, were performed. Glucose, insulin, and C-peptide were assessed in a fasting condition and during the OGTT. Growth hormine, insulin, and glucose were measured basally and every 15 minutes for 90 minutes after the injection of ghrelin.Result(s)Both groups showed an insulin response to the glucose load above the normal range. Significantly lower levels of ghrelin were detected in patients with PCOS compared to controls (108.96 ± 27.65 Fmol/mL versus 162.47 ± 42.23 Fmol/mL). Administration of ghrelin markedly enhanced GH levels in both groups (1,888.59 ± 1,209.53 ng/mL and 1,639.95 ± 631.79 ng/mL per 90 minutes as GH area under the curve, respectively), with a peak occurring 30 minutes after injection. Ghrelin also induced a trend toward an increase in plasma glucose levels, and a significant decrease in insulin concentrations in both groups.Conclusion(s)The injection of ghrelin seems to override the GH secretion defect in obese women with PCOS, and to induce glucoinsulinemic changes in both controls and obese patients with PCOS.