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Am J Physiol Endocrinol Metab 292: E1829-E1836, 2007. First published February 20, 2007; doi:10.1152/ajpendo.00682.2006
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Constant intravenous ghrelin infusion in healthy young men: clinical pharmacokinetics and metabolic effects

Esben Thyssen Vestergaard,1 Troels Krarup Hansen,1 Lars Christian Gormsen,1 Preben Jakobsen,2 Niels Moller,1 Jens Sandahl Christiansen,1 and Jens Otto Lunde Jorgensen1

1Medical Department M (Endocrinology and Diabetes), Aarhus University Hospital; and 2Department of Pharmacology, University of Aarhus, Aarhus, Denmark

Submitted 13 December 2006 ; accepted in final form 31 January 2007

Ghrelin levels fluctuate rapidly and dynamically with surges before meal times and postprandial troughs, and ghrelin increases appetite and food intake. Circulating ghrelin correlates negatively with body mass index (BMI), but obese individuals have a reduced postprandial decrease in ghrelin levels. Whether this reflects changes in secretion or clearance of ghrelin is uncertain. We therefore studied the pharmacokinetics of ghrelin in relation to anthropometric and biochemical measures. We also studied the effects of ghrelin on hormones and metabolites. In fasting humans, we used a constant infusion rate of ghrelin lasting 180 min at 5 pmol·kg body wt–1·min–1 in a randomized, double-blind, placebo-controlled crossover study. Serum ghrelin (s-ghrelin; total levels) was distributed and eliminated according to a two-compartment model. s-Ghrelin initial half-life was 24 ± 2 min and terminal half-life 146 ± 36 min, respectively. Mean residence time (MRT) of ghrelin was 93 ± 16 min. MRT correlated positively with both BMI (r = 0.51, P < 0.001) and high-density cholesterol (HDL) levels (r = 0.75, P < 0.001). Serum insulin levels remained constant during ghrelin infusion, whereas plasma glucose increased 0.3 ± 0.1 mmol/l (P < 0.01) and free fatty acid levels more than doubled (to 1.03 ± 0.08 mmol/l, P < 0.001), translating into a significant reduction of insulin sensitivity (P < 0.001). In conclusion, 1) we describe novel pharmacokinetics of ghrelin that are useful when tailoring ghrelin infusion rates in clinical experiments, 2) BMI and HDL correlate positively with MRT of infused ghrelin, and 3) supraphysiological ghrelin levels impair insulin sensitivity.

mean residence time; insulin sensitivity



Address for reprint requests and other correspondence: E. T. Vestergaard, Medical Dept. M (Endocrinology and Diabetes), Aarhus University Hospital, Dk-8000 Aarhus C, Denmark (e-mail: e.t.vestergaard{at}ki.au.dk)




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