Food fails to suppress ghrelin levels in obese humans

Ghrelin is the first circulating hormone shown to stimulate feeding in humans following systemic administration. Food consumption decreases circulating ghrelin concentrations in lean subjects but the effects of feeding have not been studied in the obese. Methods: We investigated the effects of a test meal on plasma ghrelin and leptin concentrations in 13 lean and 10 obese subjects. Results: Fasting ghrelin was significantly higher in lean than in obese subjects (857 pmol/l vs. 325 pmol/l, p=0.002) and fell by 39.5% thirty minutes after eating in the lean group before returning rapidly towards baseline values: (p=0.003). There was no change in circulating ghrelin in the obese group. Circulating leptin concentration also fell acutely 15 minutes following food intake in lean but not obese subjects (p<0.0001). Conclusions: Obese subjects do not exhibit the decline in plasma ghrelin and leptin seen after a meal in the lean. The role of the decline in leptin is unclear but given the orexigenic properties of ghrelin, the lack of suppression following a meal obese subjects could lead to increased food consumption and suggest that ghrelin may be involved in the pathophysiology of obesity.