Ghrelin and its endogenous antagonist liver-expressed antimicrobial peptide-2 (LEAP-2) are involved in GH secretion and glucose/lipids metabolism. LEAP-2 expression in conditions of metabolic impairment may be upregulated, usually pairing with a concomitant reduction in ghrelin secretion. Adult growth hormone deficiency (aGHD) is characterized by insulin resistance, weight gain, and increased fat mass. Therefore, the primary endpoint of this cross-sectional observational pilot study was to compare circulating LEAP-2 and ghrelin levels in aGHD and healthy controls. Thirty patients were included in the study. Group A included adult GHD: 15 patients, 8 females, and 7 males. Median and interquartile range age of the group was 53 (41–57) years, while BMI was 27.1 (25–35) kg/m². Group B was formed by 15 healthy controls (10 females and 5 males). Median and interquartile range age was 47 (36–57) years, while BMI 22.9 (20.8–33.1) kg/m². They were evaluated for serum glucose and insulin, HOMA-index, QUICKI-index, total/LDL/HDL cholesterol, triglycerides, IGF-1, ghrelin, and LEAP-2. Ghrelin levels in the aGHD group were significantly lower than in healthy controls. In contrast, LEAP-2 showed a trend toward higher levels, although the differences were not significant. However, the LEAP-2/Ghrelin ratio was significantly higher in aGHD. No significant correlations between ghrelin and LEAP-2 with BMI and HOMA index were found in aGHD population. However, a significant inverse correlation (r² = 0.15, p = .047) between BMI and ghrelin was evidenced when considering the whole population. Taken together, these results may suggest a body adaptation to a metabolic scenario typical of aGHD. The decrease in ghrelin production could prevent further weight gain and fat mass increase, although losing its secretagogue effect.

中文翻译：

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LEAP-2/ghrelin 在成人生长激素缺乏症中的相互作用：原因还是后果？试点研究

Ghrelin 及其内源性拮抗剂肝脏表达的抗菌肽 2 (LEAP-2) 参与 GH 分泌和葡萄糖/脂质代谢。代谢障碍条件下的 LEAP-2 表达可能会上调，通常伴随着生长素释放肽分泌的减少。成人生长激素缺乏症 (aGHD) 的特征是胰岛素抵抗、体重增加和脂肪量增加。因此，这项横断面观察性试验研究的主要终点是比较 aGHD 和健康对照组的循环 LEAP-2 和生长素释放肽水平。30 名患者被纳入研究。A 组包括成人 GHD：15 名患者，8 名女性和 7 名男性。该组的中位数和四分位距年龄为 53 (41-57) 岁，而 BMI 为 27.1 (25-35) kg/m ². B组由15名健康对照（10名女性和5名男性）组成。年龄中位数和四分位间距为 47 (36-57) 岁，而 BMI 为 22.9 (20.8-33.1) kg/m ²。他们评估了血清葡萄糖和胰岛素、HOMA 指数、QUICKI 指数、总/LDL/HDL 胆固醇、甘油三酯、IGF-1、生长素释放肽和 LEAP-2。aGHD 组的 Ghrelin 水平显着低于健康对照组。相比之下，LEAP-2 呈现出更高水平的趋势，尽管差异并不显着。然而，aGHD 中的 LEAP-2/Ghrelin 比率显着更高。在 aGHD 人群中未发现 ghrelin 和 LEAP-2 与 BMI 和 HOMA 指数之间存在显着相关性。然而，显着的负相关 ( r ²  = 0.15, p = .047）在考虑整个人群时得到证明。总之，这些结果可能表明身体适应了 aGHD 典型的代谢情况。生长素释放肽产生的减少可以防止进一步的体重增加和脂肪量增加，尽管失去了促分泌素的作用。