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Peptides. 2011 Nov;32(11):2309-18. doi: 10.1016/j.peptides.2011.03.001. Epub 2011 Mar 21.

Ghrelin and glucose homeostasis.

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  • 1Department of Internal Medicine, Erasmus MC, 3000 CA Rotterdam, The Netherlands. p.delhanty@erasmusmc.nl

Abstract

Ghrelin plays an important physiological role in modulating GH secretion, insulin secretion and glucose metabolism. Ghrelin has direct effects on pancreatic islet function. Also, ghrelin is part of a mechanism that integrates the physiological response to fasting. However, pharmacologic studies indicate the important obesogenic/diabetogenic properties of ghrelin. This is very likely of physiological relevance, deriving from a requirement to protect against seasonal periods of food scarcity by building energy reserves, predominantly in the form of fat. Available data indicate the potential of ghrelin blockade as a means to prevent its diabetogenic effects. Several studies indicate a negative correlation between ghrelin levels and the incidence of type 2 diabetes and insulin resistance. However, it is unclear if low ghrelin levels are a risk factor or a compensatory response. Direct antagonism of the receptor does not always have the desired effects, however, since it can cause increased body weight gain. Pharmacological suppression of the ghrelin/des-acyl ghrelin ratio by treatment with des-acyl ghrelin may also be a viable alternative approach which appears to improve insulin sensitivity. A promising recently developed approach appears to be through the blockade of GOAT activity, although the longer term effects of this treatment remain to be investigated.

Copyright © 2011 Elsevier Inc. All rights reserved.

PMID:
21396419
[PubMed - indexed for MEDLINE]
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