Rett patients, frequently present marked decreases in bone mineral density (BMD) beyond that expected from disuse atrophy. Recent studies indicate that ghrelin, a orexigenic peptide mainly secreted by the stomach, is involved in the regulation of bone growth and metabolism; however no clear evidence is present in the literature about the relationship of circulating total ghrelin with bone mineral density in humans. This study aimed to investigate whether there is any association between ghrelin levels, body composition and BMD in Rett patients. We studied 83 Rett girls (mean age 13.8  8.4 yrs) and 55 age-matched controls. Serum calcium, bone alkaline phosphatase, parathyroid hormone (PTH), 25-hydroxyvitamin D (25OHD) and ghrelin were measured in both Rett patients and controls. In all subjects bone mineral density at whole body (BMD-WB), at femoral neck (BMD-FN), at total femur (BMD-T) and BMC as well as body composition were measured by using a DXA machine (Hologic QDR 4500). In Rett patients the values of BMD were significantly lower than in controls at all skeletal sites. In Rett subjects BMD values, expressed as z-scores, were -1.32±2.0; -2.10±1.4 and -2.64±1.4 for BMD-WB, BMD-FN and BMD-T, respectively. The values of ghrelin were lower in Rett girl aged less than 10 years with respect to those aged 11- 20 years and those older than 20 years (1164.7382.7, 995.5413.9 and 927.5349.5 pg/ml, respectively). Ghrelin showed a significative correlations with BMD-WB, BMD-FN and with BMD-F which remained significant after adjustment for age and weight (r= -0.36; p< 0.05, r= -0.43; p< 0.05 and r=-0.44; p<0.01, respectively). Significant correlation were found also between ghrelin and lean mass (r=-0.45; p<0.05) and between ghrelin and fat mass (r=-0.43; p<0.05). Ghrelin showed a significant correlation with 25OHD (r=-0.21; p< 0.05) but not with serum PTH. By dividing the study population in tertiles on the basis of ghrelin values, we observed that fat mass was higher in the lowest with respect to the highest tertile (36.9  8.1% vs 33.3  6.4 %; p<0.050). On the contrary lean mass did not show any significant differences. In conclusion, the results of this study indicate that in Rett patients the influence of serum ghrelin on BMD is mediated by the body composition parameters. Additional studies are necessary to better understand the complex interplay of body composition and ghrelin in determining bone status.

Caffarelli, C., Gonnelli, S., Tanzilli, L., Hayek, J., Franci, B., Lucani, B., et al. (2011). The influence of ghrelin serum levels on bone mineral density and body composition in patients with Rett syndrome. BONE, 48(S2), S204-S204 [10.1016/j.bone.2011.03.463].

The influence of ghrelin serum levels on bone mineral density and body composition in patients with Rett syndrome

Caffarelli C.;Gonnelli S.;Nuti R.
2011-01-01

Abstract

Rett patients, frequently present marked decreases in bone mineral density (BMD) beyond that expected from disuse atrophy. Recent studies indicate that ghrelin, a orexigenic peptide mainly secreted by the stomach, is involved in the regulation of bone growth and metabolism; however no clear evidence is present in the literature about the relationship of circulating total ghrelin with bone mineral density in humans. This study aimed to investigate whether there is any association between ghrelin levels, body composition and BMD in Rett patients. We studied 83 Rett girls (mean age 13.8  8.4 yrs) and 55 age-matched controls. Serum calcium, bone alkaline phosphatase, parathyroid hormone (PTH), 25-hydroxyvitamin D (25OHD) and ghrelin were measured in both Rett patients and controls. In all subjects bone mineral density at whole body (BMD-WB), at femoral neck (BMD-FN), at total femur (BMD-T) and BMC as well as body composition were measured by using a DXA machine (Hologic QDR 4500). In Rett patients the values of BMD were significantly lower than in controls at all skeletal sites. In Rett subjects BMD values, expressed as z-scores, were -1.32±2.0; -2.10±1.4 and -2.64±1.4 for BMD-WB, BMD-FN and BMD-T, respectively. The values of ghrelin were lower in Rett girl aged less than 10 years with respect to those aged 11- 20 years and those older than 20 years (1164.7382.7, 995.5413.9 and 927.5349.5 pg/ml, respectively). Ghrelin showed a significative correlations with BMD-WB, BMD-FN and with BMD-F which remained significant after adjustment for age and weight (r= -0.36; p< 0.05, r= -0.43; p< 0.05 and r=-0.44; p<0.01, respectively). Significant correlation were found also between ghrelin and lean mass (r=-0.45; p<0.05) and between ghrelin and fat mass (r=-0.43; p<0.05). Ghrelin showed a significant correlation with 25OHD (r=-0.21; p< 0.05) but not with serum PTH. By dividing the study population in tertiles on the basis of ghrelin values, we observed that fat mass was higher in the lowest with respect to the highest tertile (36.9  8.1% vs 33.3  6.4 %; p<0.050). On the contrary lean mass did not show any significant differences. In conclusion, the results of this study indicate that in Rett patients the influence of serum ghrelin on BMD is mediated by the body composition parameters. Additional studies are necessary to better understand the complex interplay of body composition and ghrelin in determining bone status.
2011
Caffarelli, C., Gonnelli, S., Tanzilli, L., Hayek, J., Franci, B., Lucani, B., et al. (2011). The influence of ghrelin serum levels on bone mineral density and body composition in patients with Rett syndrome. BONE, 48(S2), S204-S204 [10.1016/j.bone.2011.03.463].
File in questo prodotto:
File Dimensione Formato  
2011 Bone ghrelin Rett.pdf

non disponibili

Tipologia: PDF editoriale
Licenza: NON PUBBLICO - Accesso privato/ristretto
Dimensione 104.16 kB
Formato Adobe PDF
104.16 kB Adobe PDF   Visualizza/Apri   Richiedi una copia

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11365/40057
 Attenzione

Attenzione! I dati visualizzati non sono stati sottoposti a validazione da parte dell'ateneo