Plasma ghrelin levels during exercise in healthy subjects and in growth hormone-deficient patients

Objective: To characterise plasma levels of the recently identified endogenous ligand for the GH secretagogue receptor (ghrelin) during submaximal aerobic exercise in healthy adults and in GH-deficient adults. Design: Eight healthy males (mean +/- S.E. age, 40.8 +/- 2.9 years) and eight hypopituitary males with verified GH deficiency (mean +/- S.E. age, 40.8 +/- 4.7 years) underwent a baseline test of their peak aerobic capacity (VO2 peak) and lactate threshold (IT) on a cycle ergometer, as well as an evaluation of body composition. The patients were then studied on two occasions in random order when they exercised for 45 min at their LT. On one occasion, GH replacement had been discontinued from the evening before, whereas on the other occasion they received their evening GH in addition to an intravenous infusion of GH (0.4 IU) during exercise the following day. The healthy subjects exercised at their LT on one occasion without GH. Results: The patients were significantly more obese and had lower VO2 max (corrected for body weight) and IT as compared with the control subjects. Exercise induced a peak in serum GH concentrations after 45 min in the control group (11.43 +/- 3.61 mug/l). Infusion of GH in the patients resulted in a peak level after 45 min, whereas no increase was detected when exercising without GH (9.77 +/- 2.40 (GH) vs 0.11 +/- 0.07 mug/l (no GH)). Plasma ghrelin levels did not change significantly with time in either study, and no correlations were detected between ghrelin levels and parameters such as GH and IGF-I levels, age or body composition. Plasma ghrelin levels were significantly lower during the study period with GH as compared with the study with no GH. Conclusions: Submaximal aerobic exercise of an intensity sufficient to stimulate GH release was not associated with significant alterations in plasma ghrelin concentrations, which indicated that systemic ghrelin is not involved in the exercise-induced stimulation of GH secretion. The observation that ghrelin levels were lower during GH replacement suggests that GH may feedback-inhibit systemic ghrelin release.