The acylated/unacylated ghrelin ratio is similar in acromegaly patients during different treatment regimens.

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The acylated/unacylated ghrelin ratio is similar in acromegaly patients during different treatment regimens.

J Clin Endocrinol Metab. 2017 Apr 11;:

Authors: Muhammad A, Delhanty PJ, Huisman M, Visser JA, van der Lelij AJ, Neggers SJ

Abstract
Background: Data on plasma acylated ghrelin (AG) and unacylated ghrelin (UAG) levels in acromegaly are limited. High ratios of AG/UAG are linked with type 2 diabetes, obesity and hyperphagia (e.g. in Prader-Willi syndrome).
Objective: To assess fasting plasma AG and UAG levels, and the AG/UAG ratio in acromegaly patients on combination treatment of long-acting somatostatin analogues and pegvisomant. As a control, we used patients controlled with pegvisomant monotherapy, and medically naïve patients with active acromegaly.
Methods: Fasting venous blood samples (combination therapy N = 60; monotherapy N = 4; naïve N = 5) were collected and directly stabilized with AEBSF to inhibit deacylation of AG. Plasma AG and UAG levels were determined by double-antibody sandwich EIA and the AG/UAG ratio was calculated.
Results: Plasma AG and UAG levels were significantly lower in acromegaly patients on combination treatment (AG: 8.5 pg/ml, 2.9-21.1 (median, interquartile range)) (UAG: 26.9 pg/ml, 11.2-42.1) compared to patients using pegvisomant alone (AG: 60.5 pg/ml, 58.8-77.4) (UAG: 153.7 pg/ml, 127.3-196.0) and medically naïve acromegaly patients (AG: 24.0 pg/ml, 12.6-49.7) (UAG: 56.3 pg/ml, 43.4-61.5). However, AG/UAG ratios were similar in all groups.
Conclusions: Although plasma AG and UAG are suppressed during combination treatment of LA-SSA and PEGV, the AG/UAG ratio remained similar. This shows that somatostatin analogues decrease both AG and UAG, which suggest that they do not alter metabolism significantly in acromegaly patients.

PMID: 28402548 [PubMed - as supplied by publisher]

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