Postprandial ghrelin response is reduced in patients with Parkinson’s disease and idiopathic REM sleep behaviour disorder: a peripheral biomarker for early Parkinson’s disease?
Abstract
Ghrelin, an orexigenic peptide, has multiple functions, which include promoting gastrointestinal motility and influencing higher brain functions. Experimental data suggest that ghrelin has neuroprotective potential in the MPTP mouse model of Parkinson's disease (PD). PD patients show delayed gastric emptying and other symptoms that may relate to disturbed excretion of ghrelin. No data are available on postprandial ghrelin response in patients with PD and idiopathic REM sleep behaviour disorder (iRBD)--a condition considered a putative preclinical stage of PD. We measured fasting and postprandial ghrelin serum concentrations in 20 healthy controls, 39 (including 19 drug-naïve) PD patients and 11 iRBD patients using a commercial radioimmunoassay for total ghrelin. For statistical analysis we employed ANCOVA and post-hoc testing with Bonferroni's method. Controls showed a decrease of mean fasting ghrelin serum concentrations in the early postprandial phase, followed by a recuperation starting 60 min after the test meal and reaching a maximum at 300 min. This recuperation was less pronounced in PD and iRBD; the slope of relative postprandial ghrelin recovery was different between the investigated groups (p = 0.007). Post-hoc testing showed a difference between controls and PD patients (p = 0.002) and between controls and iRBD patients (p = 0.037). The dynamic regulation of ghrelin in response to food intake is partially impaired in subjects at putative preclinical (iRBD) and clinical stages of PD. Reduced ghrelin excretion might increase the vulnerability of nigrostriatal dopaminergic neurons as suggested by animal studies. The impaired ghrelin excretion might qualify as a peripheral biomarker and be of diagnostic or therapeutic value.
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PD patients have reduced plasma ghrelin levels in the fasting state and impaired ghrelin response and secretion in the postprandial state.
“Evidence from PD patients has identified reduced plasma ghrelin levels in the fasting state”
From Microbiota–gut–brain axis and its therapeutic applications in neurodegenerative diseases (2024) · cites this paper as [565]
Subjects with Parkinson's disease present abnormalities in the gut microbiota accompanied by decreased levels of thiamine, folate, and ghrelin, along with altered concentration of SCFAs.
“It is in line with observations made in subjects with Parkinson's disease, who present abnormalities in the gut microbiota accompanied by decreased levels of thiamine, folate [428,429], and ghrelin [430], along with altered concentration of SCFAs [421,431].”
From The Role of Microbiota-Gut-Brain Axis in Neuropsychiatric and Neurological Disorders (2021) · cites this paper as [430]
Impaired ghrelin secretion has been reported in Parkinson's disease patients.
“and impaired ghrelin secretion has been reported in PD patients (Unger et al., 2011).”
From The Gut-Brain Axis in Parkinson’s Disease: Possibilities for Food-Based Therapies (2017) · cites this paper as Unger et al., 2011
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“, 2012), the basal plasma levels of ghrelin and the postprandial secretion of the hormone were diminished in PD patients (Fiszer et al., 2010; Unger et al., 2011).”
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“This is in contrast to previous reports of a reduction in circulating acyl-ghrelin in PD subjects.(54,55) This difference may be explained by our stratification of PD groups by cognitive performance.”
ResultEpprecht, L., Schreglmann, S. R., Goetze, O., Woitalla, D., Baumann, C. R., & Waldvogel, D. (2015) · Journal of Neurology · doi:10.1007/s00415-015-7799-z · Cited by 12 · see citing works
- Authors
- Unger, M. M., Möller, J. C., Mankel, K., Eggert, K. M., Bohne, K., Bodden, M., Stiasny-Kolster, K., Kann, P. H., Mayer, G., Tebbe, J. J., & Oertel, W. H.
- Affiliations
- Philipps University of Marburg (DE)
- Corresponding author
- Unger, Marcus M.
- Venue
- Journal of Neurology
- Published
- 2010-12-24
- Volume
- 258
- Issue
- 6
- Pages
- 982-990
- ISSN
- 0012-1037 (ISSN-L)
- 0340-5354
- 1432-1459
- OpenAlex
- W2051773180
- Cited by
- 97
- References
- 25
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 4 · 2023: 6 · 2022: 7 · 2021: 10 · 2020: 12 · 2019: 8 · 2018: 5 · 2017: 8 · 2016: 6 · 2015: 4 · 2014: 8 · 2013: 8 · 2012: 2
- FWCI
- 2.48
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Journal of Neurology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Neurology › Parkinson's Disease Mechanisms and Treatments
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Regulation of Appetite and Obesity
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neuropeptides and Animal Physiology
- Keywords
- ghrelin, Parkinson's disease, idiopathic REM sleep behavior disorder, peripheral biomarkers, gastric emptying, orexigenic peptides, nigrostriatal dopaminergic neurons, neuroprotection
- MeSH terms
- Aged, Analysis of Variance, Antiparkinson Agents, Blood Glucose, Fasting, Female, Humans, Male, Middle Aged, Parkinson Disease, Severity of Illness Index, Time Factors, Biomarkers, Postprandial Period, Area Under Curve, REM Sleep Behavior Disorder, Ghrelin
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