ESPE Abstracts

Background: Protein energy malnutrition (PEM) is a catabolic state with altered energy balance and anorexia. Ghrelin is a peptide hormone, produced by neuro-endocrine cells in the stomach, which stimulates appetite, increases food intake and growth hormone release. Although many trials have shown short term efficacy of ghrelin to increase appetite in anorexic and cachectic patients, data on the children with PEM is scarce.

Objective and hypotheses: The study was conducted to ascertain difference in plasma ghrelin levels among children with varying grades of PEM and healthy controls.

Method: A cross-sectional observational study was conducted over 1 year period in hospital setting. A total of 78 children (mean age: 26.71±16.47 months, 49 males and 29 females) including 59 with PEM and 19 healthy controls were enrolled in the study. Children with PEM were classified as mild, moderate and severe as per WHO criteria for malnutrition. Children with concomitant chronic systemic illnesses causing malnutrition were excluded from the study. The study population was divided into three groups: 36 children with severe PEM, 23 children with mild to moderate PEM and 19 children as controls. Plasma fasting ghrelin levels were measured using radioimmunoassay. Median with inter-quartile ranges (IQR) values of plasma ghrelin levels in three groups were compared.

Results: Median serum ghrelin level in severe PEM group was 1.942 ng/ml (IQR: 0.064, 9.506), in mild to moderate PEM was 17.662 ng/ml (IQR: 1.658, 40.129) and in control group was 17.525 ng/ml (IQR: 0.626, 27.361). The median ghrelin levels were significantly low (P-value, 0.027) in severe PEM group when compared to mild to moderate PEM group.

Conclusion: The plasma ghrelin levels are significantly reduced in children with severe PEM when compared to mild to moderate PEM.

Funding: This work was supported by Indian Council of Medical Research in form of Rs 15000/- thesis grant.