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Hormones and Gastrointestinal Function of Newborns

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Neonatology

Abstract

Development is a continuous process that does not stop after birth but progresses along a continuum. The intestinal absorptive process is only partially mature before 26 weeks of gestation, and gastroenteropancreatic peptides and hormones are secreted in a basal rate and can be completely stimulated or inhibited after delivery, in particular with the nutrient contact. A growing knowledge about this complex interplay among nutrients, gut peptides, and the gut under development is an important tool in the clinical care of preterm newborns. The investigation of this system in fetal and neonatal life is still ongoing. This chapter will review the data about secretion of gut peptides (GLP-1, GLP-2, oxyntomodulin, GIP, PYY, ghrelin, obestatin, motilin, and cholecystokinin) in the neonatal period with respect to full-term or preterm birth, weight status, and feeding conditions. More detailed studies on this topic could offer the physiological basis for correct nutritional supports to preterm infants as well as therapies for the necrotizing enterocolitis.

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References

  • Adams SH, Lei C, Jodka CM et al (2006) PYY[3-36] administration decreases the respiratory quotient and reduces adiposity in diet-induced obese mice. J Nutr 136:195–201

    Article  CAS  PubMed  Google Scholar 

  • Adrian TE, Smith HA, Calvert SA et al (1986) Elevated plasma peptide YY in human neonates and infants. Pediatr Res 20:1225–1227

    Article  CAS  PubMed  Google Scholar 

  • Agostoni C (2005) Ghrelin, leptin and the neurometabolic axis of breastfed and formula-fed infants. Acta Paediatr 94:523–525

    Article  PubMed  Google Scholar 

  • Althage MC, Ford EL, Wang S et al (2008) Targeted ablation of glucose-dependent insulinotropic polypeptide-producing cells in transgenic mice reduces obesity and insulin resistance induced by a high fat diet. J Biol Chem 283:18365–18376

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Amato A, Baldassano S, Mulè F (2016) GLP2: an underestimated signal for improving glycaemic control and insulin sensitivity. J Endocrinol 229:R57–R66

    Article  CAS  PubMed  Google Scholar 

  • Amin H, Holst JJ, Hartmann B et al (2008) Functional ontogeny of the proglucagon-derived peptide axis in the premature human neonate. Pediatrics 121:e180–e186

    Article  PubMed  Google Scholar 

  • Bahrami J, Longuet C, Baggio LL et al (2010) The glucagon-like peptide-2 receptor modulates islet adaptation to metabolic stress in the ob/ob mouse. Gastroenterology 139:857–868

    Article  CAS  PubMed  Google Scholar 

  • Baldassano S, Amato A (2014) GLP-2: what do we know? What are we going to discover? Regul Pept 194-195:6–10

    Article  CAS  PubMed  Google Scholar 

  • Baldassano S, Rappa F, Amato A et al (2015) GLP-2 as beneficial factor in the glucose homeostasis in mice fed a high fat diet. J Cell Physiol 230:3029–3036

    Article  CAS  PubMed  Google Scholar 

  • Baldassano S, Amato A, Caldara GF, Mulè F (2016) Glucagon-like peptide-2 treatment improves glucose dysmetabolism in mice fed a high fat diet. Endocrine 54(3):648–656

    Article  CAS  PubMed  Google Scholar 

  • Baldelli R, Bellone S, Castellino N et al (2006) Oral glucose load inhibits circulating ghrelin levels to the same extent in normal and obese children. Clin Endocrinol 64:255–259

    Article  CAS  Google Scholar 

  • Barazzoni R, Zanetti M, Ferreira C et al (2007) Relationships between desacylated and acylated ghrelin and insulin sensitivity in the metabolic syndrome. J Clin Endocrinol Metab 92:3935–3940

    Article  CAS  PubMed  Google Scholar 

  • Batterham RL, Cowley MA, Small CJ et al (2002) Gut hormone PYY(3-36) physiologically inhibits food intake. Nature 418:650–654

    Article  CAS  PubMed  Google Scholar 

  • Batterham RL, Cohen MA, Ellis SM et al (2003) Inhibition of food intake in obese subjects by peptide YY3-36. N Engl J Med 349:941–948

    Article  CAS  PubMed  Google Scholar 

  • Bellone S, Rapa A, Vivenza D et al (2004) Circulating ghrelin levels in the newborn are positively associated with gestational age. Clin Endocrinol 60:613–617

    Article  CAS  Google Scholar 

  • Bellone S, Baldelli R, Radetti G et al (2006) Ghrelin secretion in preterm neonates progressively increases and is refractory to the inhibitory effect of food intake. J Clin Endocrinol Metab 91:1929–1933

    Article  CAS  PubMed  Google Scholar 

  • Bellone S, Prodam F, Savastio S et al (2012a) Acylated and unacylated ghrelin levels in normal weight and obese children: influence of puberty and relationship with insulin, leptin and adiponectin levels. J Endocrinol Investig 35(2):191–197

    CAS  Google Scholar 

  • Bellone S, Prodam F, Savastio S et al (2012b) Acylated/unacylated ghrelin ratio in cord blood: correlation with anthropometric and metabolic parameters and pediatric lifespan comparison. Eur J Endocrinol 166:115–120

    Article  CAS  PubMed  Google Scholar 

  • Berseth CL, Nordyke CK, Valdes MG et al (1992) Responses of gastrointestinal peptides and motor activity to milk and water feedings in preterm and term infants. Pediatr Res 31:587–590

    Article  CAS  PubMed  Google Scholar 

  • Bideci A, Camurdan MO, Yesilkaya E et al (2008) Serum ghrelin, leptin and resistin levels in adolescent girls with polycystic ovary syndrome. J Obstet Gynaecol Res 34:578–584

    Article  CAS  PubMed  Google Scholar 

  • Boutsikou T, Briana DD, Boutsikou M et al (2013) Cord blood chemerin and obestatin levels in large for gestational age infants. J Matern Fetal Neonatal Med 26(2):123–126

    Article  CAS  PubMed  Google Scholar 

  • Broglio F, Gottero C, Prodam F et al (2004) Non-acylated ghrelin counteracts the metabolic but not the neuroendocrine response to acylated ghrelin in humans. J Clin Endocrinol Metab 89:3062–3065

    Article  CAS  PubMed  Google Scholar 

  • Brøns C, Saltbæk PN, Friedrichsen M et al (2016) Endocrine and metabolic diurnal rhythms in young adult men born small vs appropriate for gestational age. Eur J Endocrinol 175:29–40

    Article  PubMed  Google Scholar 

  • Bryant MG, Buchan AM, Gregor M et al (1982) Development of intestinal regulatory peptides in the human fetus. Gastroenterology 83:47–54

    CAS  PubMed  Google Scholar 

  • Bunt JC, Salbe AD, Tschop MH et al (2003) Cross-sectional and prospective relationships of fasting plasma ghrelin concentrations with anthropometric measures in pima Indian children. J Clin Endocrinol Metab 88:3756–3761

    Article  CAS  PubMed  Google Scholar 

  • Burrin DG, Stoll B (2002) Key nutrients and growth factors for the neonatal gastrointestinal tract. Clin Perinatol 29:65–96

    Article  CAS  PubMed  Google Scholar 

  • Calanna S, Christensen M, Holst JJ et al (2013) Secretion of glucose-dependent insulinotropic polypeptide in patients with type 2 diabetes: systematic review and meta-analysis of clinical studies. Diabetes Care 36:3346–3352

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Cani PD, Possemiers S, Van de Wiele T et al (2009) Changes in gut microbiota control inflammation in obese mice through a mechanism involving GLP-2-driven improvement of gut permeability. Gut 58:1091–1103

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Cesur G, Ozguner F, Yilmaz N, Dundar B (2012) The relationship between ghrelin and adiponectin levels in breast milk and infant serum and growth of infants during early postnatal life. J Physiol Sci 62(3):185–190

    Article  CAS  PubMed  Google Scholar 

  • Chanoine JP, Yeung LP, Wong AC, Birmingham CL (2002) Immunoreactive ghrelin in human cord blood: relation to anthropometry, leptin, and growth hormone. J Pediatr Gastroenterol Nutr 35:282–286

    Article  CAS  PubMed  Google Scholar 

  • Chaudhri OB, Wynne K, Bloom SR (2008) Can gut hormones control appetite and prevent obesity? Diabetes Care 31(Suppl 2):S284–S289

    Article  CAS  PubMed  Google Scholar 

  • Chen X, Du X, Zhu J et al (2012) Correlations of circulating peptide YY and ghrelin with body weight, rate of weight gain, and time required to achieve the recommended daily intake in preterm infants. Braz J Med Biol Res 45:656–664

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Chiesa C, Osborn JF, Haass C et al (2008) Ghrelin, leptin, IGF-1, IGFBP-3, and insulin concentrations at birth: is there a relationship with foetal growth and neonatal anthropometry? Clin Chem 54:550–558

    Article  CAS  PubMed  Google Scholar 

  • Choi K, Roh SG, Hong YH et al (2003) The role of ghrelin and growth hormone secretagogues receptor on rat adipogenesis. Endocrinology 144:754–759

    Article  CAS  PubMed  Google Scholar 

  • Cohen MA, Ellis SM, le Roux CW et al (2003) Oxyntomodulin suppresses appetite and reduces food intake in humans. J Clin Endocrinol Metab 88:4696–4701

    Article  CAS  PubMed  Google Scholar 

  • Corpeleijn WE, van Vliet I, de Gast-Bakker DA et al (2008) Effect of enteral IGF-1 supplementation on feeding tolerance, growth, and gut permeability in enterally fed premature neonates. J Pediatr Gastroenterol Nutr 46:184–190

    Article  CAS  PubMed  Google Scholar 

  • Cortelazzi D, Cappiello V, Morpurgo PS et al (2003) Circulating levels of ghrelin in human fetuses. Eur J Endocrinol 149:111–116

    Article  CAS  PubMed  Google Scholar 

  • Covasa M, Marcuson JK, Ritter RC (2001) Diminished satiation in rats exposed to elevated levels of endogenous or exogenous cholecystokinin. Am J Phys Regul Integr Comp Phys 280:R331–R337

    CAS  Google Scholar 

  • Cummings DE, Weigle DS, Frayo RS et al (2002) Plasma ghrelin levels after diet-induced weight loss or gastric bypass surgery. N Engl J Med 346:1623–1630

    Article  PubMed  Google Scholar 

  • Dakin CL, Gunn I, Small CJ et al (2001) Oxyntomodulin inhibits food intake in the rat. Endocrinology 142:4244–4250

    Article  CAS  PubMed  Google Scholar 

  • Dakin CL, Small CJ, Batterham RL et al (2004) Peripheral oxyntomodulin reduces food intake and body weight gain in rats. Endocrinology 145:2687–2695

    Article  CAS  PubMed  Google Scholar 

  • Dasopoulou M, Briana DD, Boutsikou T et al (2015) Motilin and gastrin secretion and lipid profile in preterm neonates following prebiotics supplementation: a double-blind randomized controlled study. JPEN J Parenter Enteral Nutr 39(3):359–368

    Article  CAS  PubMed  Google Scholar 

  • De Clercq P, Springer S, Depoortere I, Peeters TL (1998) Motilin in human milk: identification and stability during digestion. Life Sci 63:1993–2000

    Article  PubMed  Google Scholar 

  • de Moura EG, Lisboa PC, Passos MC (2008) Neonatal programming of neuroimmunomodulation–role of adipocytokines and neuropeptides. Neuroimmunomodulation 15:176–188

    Article  PubMed  CAS  Google Scholar 

  • Degen L, Oesch S, Casanova M et al (2005) Effect of peptide YY3-36 on food intake in humans. Gastroenterology 129:1430–1436

    Article  CAS  PubMed  Google Scholar 

  • Delhanty PJ, Neggers SJ, van der Lely AJ (2012) Mechanisms in endocrinology: ghrelin: the differences between acyl- and des-acyl ghrelin. Eur J Endocrinol 167:601–608

    Article  CAS  PubMed  Google Scholar 

  • Díaz M, Bassols J, Sebastiani G et al (2015) Circulating GLP-1 in infants born small-for-gestational-age: breast-feeding versus formula-feeding. Int J Obes 39:1501–1503

    Article  CAS  Google Scholar 

  • Dong CX, Zhao W, Solomon C et al (2014) The intestinal epithelial insulin-like growth factor-1 receptor links glucagon-like peptide-2 action to gut barrier function. Endocrinology 155:370–379

    Article  PubMed  CAS  Google Scholar 

  • Drucker DJ (2002) Biological actions and therapeutic potential of the glucagon-like peptides. Gastroenterology 122:531–544

    Article  CAS  PubMed  Google Scholar 

  • Drucker DJ, Yusta B (2014) Physiology and pharmacology of the enteroendocrine hormone glucagon-like peptide-2. Annu Rev Physiol 76:561–583

    Article  CAS  PubMed  Google Scholar 

  • Du X, Kosinski JR, Lao J et al (2012) Differential effects of oxyntomodulin and GLP-1 on glucose metabolism. Am J Physiol Endocrinol Metab 303:E265–E271

    Article  CAS  PubMed  Google Scholar 

  • Fallucca F, Kuhl C, Lauritsen KB et al (1985) Gastric inhibitory polypeptide (GIP) concentration in human amniotic fluid. Horm Metab Res 17:251–255

    Article  CAS  PubMed  Google Scholar 

  • Flatt PR (2007) Effective surgical treatment of obesity may be mediated by ablation of the lipogenic gut hormone gastric inhibitory polypeptide (GIP): evidence and clinical opportunity for development of new obesity-diabetes drugs? Diab Vasc Dis Res 4:151–153

    Article  PubMed  Google Scholar 

  • Flatt PR (2008) Dorothy Hodgkin Lecture 2008. Gastric inhibitory polypeptide (GIP) revisited: a new therapeutic target for obesity-diabetes? Diabet Med 25:759–764

    Article  CAS  PubMed  Google Scholar 

  • Garcia-Diaz D, Campion J, Milagro FI, Martinez JA (2007) Adiposity dependent apelin gene expression: relationships with oxidative and inflammation markers. Mol Cell Biochem 305:87–94

    Article  CAS  PubMed  Google Scholar 

  • Gardiner JV, Jayasena CN, Bloom SR (2008) Gut hormones: a weight off your mind. J Neuroendocrinol 20:834–841

    Article  CAS  PubMed  Google Scholar 

  • Gault VA, Irwin N, Green BD et al (2005) Chemical ablation of gastric inhibitory polypeptide receptor action by daily (Pro3)GIP administration improves glucose tolerance and ameliorates insulin resistance and abnormalities of islet structure in obesity-related diabetes. Diabetes 54:2436–2446

    Article  CAS  PubMed  Google Scholar 

  • Gauna C, Delhanty PJ, Hofland LJ et al (2005) Ghrelin stimulates, whereas des-octanoyl ghrelin inhibits, glucose output by primary hepatocytes. J Clin Endocrinol Metab 90:1055–1060

    Article  CAS  PubMed  Google Scholar 

  • Geloneze B, Lima MM, Pareja JC et al (2013) Association of insulin resistance and GLP-2 secretion in obesity: a pilot study. Arq Bras Endocrinol Metabol 57:632–635

    Article  PubMed  Google Scholar 

  • Ghigo E, Arvat E, Giordano R et al (2001) Biologic activities of growth hormone secretagogues in humans. Endocrine 14:87–93

    Article  CAS  PubMed  Google Scholar 

  • Gibbs J, Young RC, Smith GP (1973) Cholecystokinin decreases food intake in rats. J Comp Physiol Psychol 84:488–495

    Article  CAS  PubMed  Google Scholar 

  • Gil-Campos M, Aguilera CM, Canete R, Gil A (2006) Ghrelin: a hormone regulating food intake and energy homeostasis. Br J Nutr 96:201–226

    Article  CAS  PubMed  Google Scholar 

  • Gourcerol G, St-Pierre DH, Tache Y (2007) Lack of obestatin effects on food intake: should obestatin be renamed ghrelin-associated peptide (GAP)? Regul Pept 141:1–7

    Article  CAS  PubMed  Google Scholar 

  • Grigoryan M, Kedees MH, Guz Y, Teitelman G (2012) Phenotype of entero-endocrine L cells becomes restricted during development. Dev Dyn 241:1986–1992

    Article  CAS  PubMed  Google Scholar 

  • Gualillo O, Caminos J, Blanco M et al (2001) Ghrelin, a novel placental-derived hormone. Endocrinology 142:788–794

    Article  CAS  PubMed  Google Scholar 

  • Guan X, Shi X, Li X, Chang B et al (2012) GLP-2 receptor in POMC neurons suppresses feeding behavior and gastric motility. Am J Physiol Endocrinol Metab 303:E853–E864

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Han L, Li M, Yu X et al (2014) Assay of adiponectin, leptin, true insulin and ghrelin levels in preterm human milk, and its relationship with infants growth. Zhonghua Er Ke Za Zhi 52(7):510–515

    PubMed  Google Scholar 

  • Harada T, Nakahara T, Yasuhara D et al (2008) Obestatin, acyl ghrelin, and des-acyl ghrelin responses to an oral glucose tolerance test in the restricting type of anorexia nervosa. Biol Psychiatry 63:245–247

    Article  CAS  PubMed  Google Scholar 

  • Heijboer AC, Pijl H, Van den Hoek AM et al (2006) Gut-brain axis: regulation of glucose metabolism. J Neuroendocrinol 18:883–894

    Article  CAS  PubMed  Google Scholar 

  • Hellstrom PM, Geliebter A, Naslund E et al (2004) Peripheral and central signals in the control of eating in normal, obese and binge-eating human subjects. Br J Nutr 92(Suppl 1):S47–S57

    Article  PubMed  CAS  Google Scholar 

  • Heptulla RA, Tamborlane WV, Cavaghan M et al (2000) Augmentation of alimentary insulin secretion despite similar gastric inhibitory peptide (GIP) responses in juvenile obesity. Pediatr Res 47:628–633

    Article  CAS  PubMed  Google Scholar 

  • Higgins PB, Fernandez JR, Garvey WT et al (2008) Entero-insular axis and postprandial insulin differences in African American and European American children. Am J Clin Nutr 88:1277–1283

    CAS  PubMed  PubMed Central  Google Scholar 

  • Hill ME, Asa SL, Drucker DJ (1999) Essential requirement for Pax6 in control of enteroendocrine proglucagon gene transcription. Mol Endocrinol 13:1474–1486

    Article  CAS  PubMed  Google Scholar 

  • Holst JJ (2007) The physiology of glucagon-like peptide 1. Physiol Rev 87:1409–1439

    Article  CAS  PubMed  Google Scholar 

  • Holst B, Egerod KL, Schild E et al (2007) GPR39 signaling is stimulated by zinc ions but not by obestatin. Endocrinology 148:13–20

    Article  CAS  PubMed  Google Scholar 

  • http://www.ema.europa.eu/ema/index.jsp?curl=pages/medicines/human/orphans/2009/11/human_orphan_000210.jsp&mid=WC0b01ac058001d12b

  • Hubler A, Rippel C, Kauf E et al (2006) Associations between ghrelin levels in serum of preterm infants and enteral nutritional state during the first 6 months after birth. Clin Endocrinol 65:611–616

    Article  CAS  Google Scholar 

  • Ilcol YO, Hizli B (2007) Active and total ghrelin concentrations increase in breast milk during lactation. Acta Paediatr 96:1632–1639

    Article  PubMed  Google Scholar 

  • Irwin N, Flatt PR (2015) New perspectives on exploitation of incretin peptides for the treatment of diabetes and related disorders. World J Diabetes 6:1285–1295

    Article  PubMed  PubMed Central  Google Scholar 

  • Itoh Z (1997) Motilin and clinical application. Peptides 18:593–608

    Article  CAS  PubMed  Google Scholar 

  • James RJ, Drewett RF, Cheetham TD (2004) Low cord ghrelin levels in term infants are associated with slow weight gain over the first 3 months of life. J Clin Endocrinol Metab 89:3847–3850

    Article  CAS  PubMed  Google Scholar 

  • Janik JS, Track NS, Filler RM (1982) Motilin, human pancreatic polypeptide, gastrin, and insulin plasma concentrations in fasted children. J Pediatr 101:51–56

    Article  CAS  PubMed  Google Scholar 

  • Jia X, Brown JC, Ma P et al (1995) Effects of glucose-dependent insulinotropic polypeptide and glucagon-like peptide-I-(7-36) on insulin secretion. Am J Phys 268:E645–E651

    CAS  Google Scholar 

  • Kahveci H, Laloglu F, Kilic O, Ciftel M, Kara M, Laloglu E, Yildirim A, Orbak Z, Ertekin V, Cesur Y (2015) Fasting and postprandial glucose, insulin, leptin, and ghrelin values in preterm babies and their mothers: relationships among their levels, foetal growth, and neonatal anthropometry. J Matern Fetal Neonatal Med 28(8):916–921

    Article  CAS  PubMed  Google Scholar 

  • Kalies H, Heinrich J, Borte N et al (2005) The effect of breastfeeding on weight gain in infants: results of a birth cohort study. Eur J Med Res 10:36–42

    CAS  PubMed  Google Scholar 

  • Kasa-Vubu JZ, Rosenthal A, Murdock EG, Welch KB (2007) Impact of fatness, fitness, and ethnicity on the relationship of nocturnal ghrelin to 24-hour luteinizing hormone concentrations in adolescent girls. J Clin Endocrinol Metab 92:3246–3252

    Article  CAS  PubMed  Google Scholar 

  • Kawamata R, Suzuki Y, Yada Y et al (2014) Gut hormone profiles in preterm and term infants during the first 2 months of life. J Pediatr Endocrinol Metab 27(7–8):717–723

    CAS  PubMed  Google Scholar 

  • Kawamata R, Suzuki Y, Yada Y et al (2015) Gut hormones of preterm infants with abdominal symptoms and hypothyroxinemia. Pediatr Int 57:614–619

    Article  CAS  PubMed  Google Scholar 

  • Kim SJ, Nian C, Karunakaran S et al (2012) GIP-overexpressing mice demonstrate reduced diet-induced obesity and steatosis, and improved glucose homeostasis. PLoS One 7:e40156

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • King KC, Oliven A, Kalhan SC (1989) Functional enteroinsular axis in full-term newborn infants. Pediatr Res 25:490–495

    Article  CAS  PubMed  Google Scholar 

  • Knip M, Kaapa P, Koivisto M (1993) Hormonal enteroinsular axis in newborn infants of insulin-treated diabetic mothers. J Clin Endocrinol Metab 77:1340–1344

    CAS  PubMed  Google Scholar 

  • Kojima M, Kangawa K (2005) Ghrelin: structure and function. Physiol Rev 85:495–522

    Article  CAS  PubMed  Google Scholar 

  • Konturek SJ, Konturek JW, Pawlik T, Brzozowski T (2004) Brain-gut axis and its role in the control of food intake. J Physiol Pharmacol 55:137–154

    CAS  PubMed  Google Scholar 

  • Lambeir AM, Durinx C, Scharpe S, De Meester I (2003) Dipeptidyl-peptidase IV from bench to bedside: an update on structural properties, functions, and clinical aspects of the enzyme DPP IV. Crit Rev Clin Lab Sci 40:209–294

    Article  CAS  PubMed  Google Scholar 

  • Lanyi E, Varnagy A, Kovacs KA et al (2008) Ghrelin and acyl ghrelin in preterm infants and maternal blood: relationship with endocrine and anthropometric measures. Eur J Endocrinol 158:27–33

    Article  CAS  PubMed  Google Scholar 

  • Lebenthal A, Lebenthal E (1999) The ontogeny of the small intestinal epithelium. JPEN J Parenter Enteral Nutr 23:S3–S6

    Article  CAS  PubMed  Google Scholar 

  • Leite-Moreira AF, Soares JB (2007) Physiological, pathological and potential therapeutic roles of ghrelin. Drug Discov Today 12:276–288

    Article  CAS  PubMed  Google Scholar 

  • Lothe L, Ivarsson SA, Lindberg T (1987) Motilin, vasoactive intestinal peptide and gastrin in infantile colic. Acta Paediatr Scand 76:316–320

    Article  CAS  PubMed  Google Scholar 

  • Lu M, Wheeler MB, Leng XH, Boyd AE III (1993) Stimulation of insulin secretion and insulin gene expression by gastric inhibitory polypeptide. Trans Assoc Am Phys 106:42–53

    CAS  PubMed  Google Scholar 

  • Lucas A, Sarson DL, Bloom SR, Aynsley-Green A (1980) Developmental aspects of gastric inhibitory polypeptide (GIP) and its possible role in the enteroinsular axis in neonates. Acta Paediatr Scand 69:321–325

    Article  CAS  PubMed  Google Scholar 

  • Mahmoud EL, Benirschke K, Vaucher YE, Poitras P (1988) Motilin levels in term neonates who have passed meconium prior to birth. J Pediatr Gastroenterol Nutr 7:95–99

    Article  CAS  PubMed  Google Scholar 

  • Marchini G, Linden A (1992) Cholecystokinin, a satiety signal in newborn infants? J Dev Physiol 17:215–219

    CAS  PubMed  Google Scholar 

  • Martin GR, Beck PL, Sigalet DL (2006) Gut hormones, and short bowel syndrome: the enigmatic role of glucagon-like peptide-2 in the regulation of intestinal adaptation. World J Gastroenterol 12:4117–4129

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Mechanick JI, Kushner RF, Sugerman HJ et al (2008) American Association of Clinical Endocrinologists, the obesity Society, and American Society for Metabolic & Bariatric Surgery Medical guidelines for clinical practice for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient. Endocr Pract 14(Suppl 1):1–83

    Article  PubMed  Google Scholar 

  • Misra M, Miller KK, Cord J et al (2007) Relationships between serum adipokines, insulin levels, and bone density in girls with anorexia nervosa. J Clin Endocrinol Metab 92:2046–2052

    Article  CAS  PubMed  Google Scholar 

  • Misra M, Prabhakaran R, Miller KK et al (2008) Prognostic indicators of changes in bone density measures in adolescent girls with anorexia nervosa-II. J Clin Endocrinol Metab 93:1292–1297

    Article  CAS  PubMed  Google Scholar 

  • Mitrovic O, Cokic V, Dikic D et al (2014) Ghrelin receptors in human gastrointestinal tract during prenatal and early postnatal development. Peptides 57:1–11

    Article  CAS  PubMed  Google Scholar 

  • Moran TH (2000) Cholecystokinin and satiety: current perspectives. Nutrition 16:858–865

    Article  CAS  PubMed  Google Scholar 

  • Müller TD, Nogueiras R, Andermann ML et al (2015) Ghrelin. Mol Metab 4:437–460

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Mulvihill SJ, Stone MM, Debas HT, Fonkalsrud EW (1985) The role of amniotic fluid in foetal nutrition. J Pediatr Surg 20:668–672

    Article  CAS  PubMed  Google Scholar 

  • Nagasaki H, Ohta T (2015) Extra-uterine growth and adipocytokines in appropriate-for-gestational-age preterm infants. Pediatr Int. https://doi.org/10.1111/ped.12896

    Article  PubMed  Google Scholar 

  • Nagata E, Nakagawa Y, Yamaguchi R et al (2011) Altered gene expressions of ghrelin, PYY, and CCK in the gastrointestinal tract of the hyperphagic intrauterine growth restriction rat offspring. Horm Metab Res 43(3):178–182

    Article  CAS  PubMed  Google Scholar 

  • Naitoh R, Miyawaki K, Harada N et al (2008) Inhibition of GIP signaling modulates adiponectin levels under high-fat diet in mice. Biochem Biophys Res Commun 376:21–25

    Article  CAS  PubMed  Google Scholar 

  • Nakahara T, Harada T, Yasuhara D et al (2008) Plasma obestatin concentrations are negatively correlated with body mass index, insulin resistance index, and plasma leptin concentrations in obesity and anorexia nervosa. Biol Psychiatry 64:252–255

    Article  CAS  PubMed  Google Scholar 

  • Naslund E, Barkeling B, King N et al (1999) Energy intake and appetite are suppressed by glucagon-like peptide-1 (GLP-1) in obese men. Int J Obes Relat Metab Disord 23:304–311

    Article  CAS  PubMed  Google Scholar 

  • Neary NM, Goldstone AP, Bloom SR (2004) Appetite regulation: from the gut to the hypothalamus. Clin Endocrinol 60:153–160

    Article  Google Scholar 

  • Nishikubo T, Yamakawa A, Kamitsuji H et al (2005) Identification of the motilin cells in duodenal epithelium of premature infants. Pediatr Int 47(3):248–251

    Article  PubMed  Google Scholar 

  • O'Mahony SM, Felice VD, Nally K et al (2014) Disturbance of the gut microbiota in early-life selectively affects visceral pain in adulthood without impacting cognitive or anxiety-related behaviors in male rats. Neuroscience 277:885–901

    Article  CAS  PubMed  Google Scholar 

  • Ozaki T, Mohammad S, Morioka E et al (2013) Infant satiety depends on transient expression of cholecystokinin-1 receptors on ependymal cells lining the third ventricle in mice. J Physiol 591(5):1295–1312

    Article  PubMed  Google Scholar 

  • Ozer EA, Holst JJ, Duman N et al (2009) The relationship between glucagon-like peptide 2 and feeding intolerance in preterm infants. J Trop Pediatr 55:276–277

    Article  PubMed  Google Scholar 

  • Padidela R, Patterson M, Sharief N et al (2009) Elevated basal and post-feed glucagon-like peptide 1 (GLP-1) concentrations in the neonatal period. Eur J Endocrinol 160:53–58

    Article  CAS  PubMed  Google Scholar 

  • Paik KH, Choe YH, Park WH et al (2006) Suppression of acylated ghrelin during oral glucose tolerance test is correlated with whole-body insulin sensitivity in children with Prader-Willi syndrome. J Clin Endocrinol Metab 91:1876–1881

    Article  CAS  PubMed  Google Scholar 

  • Pais R, Gribble FM, Reimann F (2016) Stimulation of incretin secreting cells. Ther Adv Endocrinol Metab 7:24–42

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Perala MM, Kajantie E, Valsta LM et al (2013) Early growth and postprandial appetite regulatory hormone responses. Br J Nutr 110:1591–1600

    Article  PubMed  CAS  Google Scholar 

  • Persaud SJ, Bewick GA (2014) Peptide YY: more than just an appetite regulator. Diabetologia 57:1762–1769

    Article  PubMed  Google Scholar 

  • Pocai A (2013) Action and therapeutic potential of oxyntomodulin. Mol Metab 3:241–251

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Poitras P, Peeters TL (2008) Motilin. Curr Opin Endocrinol Diabetes Obes 15:54–57

    Article  CAS  PubMed  Google Scholar 

  • Pomerants T, Tillmann V, Jurimae J, Jurimae T (2006) Relationship between ghrelin and anthropometrical, body composition parameters and testosterone levels in boys at different stages of puberty. J Endocrinol Investig 29:962–967

    Article  CAS  Google Scholar 

  • Prodam F, Filigheddu N (2014) Ghrelin gene products in acute and chronic inflammation. Arch Immunol Ther Exp (Warsz) 62(5):369–3684

    Article  CAS  Google Scholar 

  • Prodam F, Me E, Riganti F et al (2006) The nutritional control of ghrelin secretion in humans: the effects of enteral vs. parenteral nutrition. Eur J Nutr 45:399–405

    Article  CAS  PubMed  Google Scholar 

  • Prodam F, Bellone S, Corneli G et al (2008) Ghrelin: a molecular target for weight regulation, glucose and lipid metabolism. Recent Patents Endocrine Metab Immune Drug Discov 2(3):1–1

    Article  Google Scholar 

  • Prodam F, Bellone S, Ricotti R et al (2011) Ghrelin regulation in epilepsy. Underlying mechanisms of epilepsy. InTech, Prof. Fatima Shad Kaneez (ed). ISBN:978–953–307-765-9, pp 151–180. Available from: http://www.intechopen.com/books/underlying-mechanisms-ofepilepsy/ghrelin-regulation-in-epilepsy

    Google Scholar 

  • Prodam F, Monzani A, Ricotti R et al (2014a) Systematic review of ghrelin response to food intake in pediatric age, from neonates to adolescents. J Clin Endocrinol Metab 99(5):1556–1568

    Article  CAS  PubMed  Google Scholar 

  • Prodam F, Cadario F, Bellone S et al (2014b) Obestatin levels are associated with C-peptide and antiinsulin antibodies at the onset, whereas unacylated and acylated ghrelin levels are not predictive of long-term metabolic control in children with type 1 diabetes. J Clin Endocrinol Metab 99(4):E599–E607

    Article  CAS  PubMed  Google Scholar 

  • Qader SS, Hakanson R, Rehfeld JF et al (2008) Proghrelin-derived peptides influence the secretion of insulin, glucagon, pancreatic polypeptide and somatostatin: a study on isolated islets from mouse and rat pancreas. Regul Pept 146:230–237

    Article  CAS  PubMed  Google Scholar 

  • Ranganath LR (2008a) The entero-insular axis: implications for human metabolism. Clin Chem Lab Med 46:43–56

    Article  CAS  PubMed  Google Scholar 

  • Ranganath LR (2008b) Incretins: pathophysiological and therapeutic implications of glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1. J Clin Pathol 61:401–409

    Article  CAS  PubMed  Google Scholar 

  • Savino F, Fissore MF, Grassino EC et al (2005) Ghrelin, leptin and IGF-I levels in breast-fed and formula-fed infants in the first years of life. Acta Paediatr 94:531–537

    Article  PubMed  Google Scholar 

  • Savino F, Grassino EC, Fissore MF et al (2006a) Ghrelin, motilin, insulin concentration in healthy infants in the first months of life: relation to fasting time and anthropometry. Clin Endocrinol 65:158–162

    Article  CAS  Google Scholar 

  • Savino F, Grassino EC, Guidi C et al (2006b) Ghrelin and motilin concentration in colicky infants. Acta Paediatr 95:738–741

    Article  PubMed  Google Scholar 

  • Savino F, Lupica MM, Liguori SA et al (2012a) Ghrelin and feeding behaviour in preterm infants. Early Hum Dev 88:S51–S55

    Article  CAS  PubMed  Google Scholar 

  • Savino F, Benetti S, Lupica MM et al (2012b) Ghrelin and obestatin in infants, lactating mothers and breast milk. Horm Res Paediatr 78(5–6):297–303

    Article  CAS  PubMed  Google Scholar 

  • Schmidt PT, Naslund E, Gryback P et al (2003) Peripheral administration of GLP-2 to humans has no effect on gastric emptying or satiety. Regul Pept 116:21–25

    Article  CAS  PubMed  Google Scholar 

  • Sharman-Koendjbiharie M, Hopman WP, Piena-Spoel M et al (2002) Gut hormones in preterm infants with necrotizing enterocolitis during starvation and reintroduction of enteral nutrition. J Pediatr Gastroenterol Nutr 35:674–679

    Article  CAS  PubMed  Google Scholar 

  • Shimizu T, Kitamura T, Yoshikawa N et al (2007) Plasma levels of active ghrelin until 8 weeks after birth in preterm infants: relationship with anthropometric and biochemical measures. Arch Dis Child Fetal Neonatal Ed 92:F291–F292

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Shoji H, Watanabe A, Ikeda N et al (2016) Influence of gestational age on serum incretin levels in preterm infants. J Dev Orig Health Dis 25:1–4

    Google Scholar 

  • Shulman DI, Kanarek K (1993) Gastrin, motilin, insulin, and insulin-like growth factor-I concentrations in very-low-birth-weight infants receiving enteral or parenteral nutrition. JPEN J Parenter Enteral Nutr 17:130–133

    Article  CAS  PubMed  Google Scholar 

  • Siahanidou T, Mandyla H, Vounatsou M et al (2005) Circulating peptide YY concentrations are higher in preterm than full-term infants and correlate negatively with body weight and positively with serum ghrelin concentrations. Clin Chem 51:2131–2137

    Article  CAS  PubMed  Google Scholar 

  • Siahanidou T, Mandyla H, Militsi H et al (2007) Peptide YY (3-36) represents a high percentage of total PYY immunoreactivity in preterm and full-term infants and correlates independently with markers of adiposity and serum ghrelin concentrations. Pediatr Res 62:200–203

    Article  PubMed  Google Scholar 

  • Siahanidou T, Margeli A, Tsirogianni C et al (2015) Elevated circulating ghrelin, but not peptide YY(3-36) levels, in term neonates with infection. Clin Chem Lab Med 53(11):1815–1824

    Article  CAS  PubMed  Google Scholar 

  • Sigalet DL, Martin G, Meddings J et al (2004) GLP-2 levels in infants with intestinal dysfunction. Pediatr Res 56:371–376

    Article  CAS  PubMed  Google Scholar 

  • Sigalet DL, Brindle M, Boctor D et al (2015) A safety and dosing study of glucagon-like peptide 2 in children with intestinal failure. JPEN J Parenter Enteral Nutr. 56(3):371–376

    Google Scholar 

  • Skow MA, Bergmann NC, Knop FK (2016) Diabetes and obesity treatment based on dual incretin receptor activation – “twincretins”. Diabetes Obes Metab 18(9):847–854. https://doi.org/10.1111/dom.12685

    Article  CAS  PubMed  Google Scholar 

  • Soriano-Guillen L, Barrios V, Chowen JA et al (2004) Ghrelin levels from foetal life through early adulthood: relationship with endocrine and metabolic and anthropometric measures. J Pediatr 144:30–35

    Article  CAS  PubMed  Google Scholar 

  • Spreckley E, Murphy KG (2015) The L-Cell in nutritional sensing and the regulation of appetite. Front Nutr 2:23

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Stadlbauer U, Woods SC, Langhans W, Meyer U (2015) PYY3–36: beyond food intake. Front Neuroendocrinol 38:1–11

    Article  CAS  PubMed  Google Scholar 

  • Stock S, Leichner P, Wong AC et al (2005) Ghrelin, peptide YY, glucose-dependent insulinotropic polypeptide, and hunger responses to a mixed meal in anorexic, obese, and control female adolescents. J Clin Endocrinol Metab 90:2161–2168

    Article  CAS  PubMed  Google Scholar 

  • Stoll B, Puiman PJ, Cui L et al (2012) Continuous parenteral and enteral nutrition induces metabolic dysfunction in neonatal pigs. JPEN J Parenter Enteral Nutr 36:538–550

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Tang SQ, Jiang QY, Zhang YL et al (2008) Obestatin: its physicochemical characteristics and physiological functions. Peptides 29:639–645

    Article  CAS  PubMed  Google Scholar 

  • Tang-Christensen M, Larsen PJ, Thulesen J et al (2000) The proglucagon-derived peptide, glucagon-like peptide-2, is a neurotransmitter involved in the regulation of food intake. Nat Med 6:802–807

    Article  CAS  PubMed  Google Scholar 

  • Teitelbaum DH, Han-Markey T, Drongowski RA et al (1997) Use of cholecystokinin to prevent the development of parenteral nutrition-associated cholestasis. JPEN J Parenter Enteral Nutr 21:100–103

    Article  CAS  PubMed  Google Scholar 

  • Thompson NM, Gill DA, Davies R et al (2004) Ghrelin and des-octanoyl ghrelin promote adipogenesis directly in vivo by a mechanism independent of the type 1a growth hormone secretagogue receptor. Endocrinology 145:234–242

    Article  CAS  PubMed  Google Scholar 

  • Tomasetto C, Karam SM, Ribieras S et al (2000) Identification and characterization of a novel gastric peptide hormone: the motilin-related peptide. Gastroenterology 119:395–405

    Article  CAS  PubMed  Google Scholar 

  • Tornhage CJ, Serenius F, Uvnas-Moberg K, Lindberg T (1995) Plasma somatostatin and cholecystokinin levels in preterm infants and their mothers at birth. Pediatr Res 37:771–776

    Article  CAS  PubMed  Google Scholar 

  • Tornhage CJ, Serenius F, Uvnas-Moberg K, Lindberg T (1996) Plasma somatostatin and cholecystokinin levels in preterm infants during the first day of life. Biol Neonate 70:311–321

    Article  CAS  PubMed  Google Scholar 

  • Tornhage CJ, Serenius F, Uvnas-Moberg K, Lindberg T (1998) Plasma somatostatin and cholecystokinin levels in preterm infants during kangaroo care with and without nasogastric tube-feeding. J Pediatr Endocrinol Metab 11:645–651

    Article  CAS  PubMed  Google Scholar 

  • Uvnas-Moberg K, Marchini G, Winberg J (1993) Plasma cholecystokinin concentrations after breast feeding in healthy 4 day old infants. Arch Dis Child 68:46–48

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Valderas JP, Padilla O, Solari S et al (2014) Feeding and bone turnover in gastric bypass. J Clin Endocrinol Metab 99:491–497

    Article  CAS  PubMed  Google Scholar 

  • Valsamakis G, Papatheodorou DC, Naouma A et al (2014) Neonatal birthwaist is positively predicted by second trimester maternal active ghrelin, a pro-appetite hormone, and negatively associated with third trimester maternal leptin, a pro-satiety hormone. Early Hum Dev 90:487–492

    Article  CAS  PubMed  Google Scholar 

  • Van den Hoek AM, Heijboer AC, Corssmit EP et al (2004) PYY3-36 reinforces insulin action on glucose disposal in mice fed a high-fat diet. Diabetes 53:1949–1952

    Article  PubMed  Google Scholar 

  • Verdich C, Flint A, Gutzwiller JP et al (2001) A meta-analysis of the effect of glucagon-like peptide-1 (7-36) amide on ad libitum energy intake in humans. J Clin Endocrinol Metab 86:4382–4389

    CAS  PubMed  Google Scholar 

  • Vilsboll T, Krarup T, Sonne J et al (2003) Incretin secretion in relation to meal size and body weight in healthy subjects and people with type 1 and type 2 diabetes mellitus. J Clin Endocrinol Metab 88:2706–2713

    Article  CAS  PubMed  Google Scholar 

  • Wagner CL (2002) Amniotic fluid and human milk: a continuum of effect? J Pediatr Gastroenterol Nutr 34:513–514

    Article  PubMed  Google Scholar 

  • Warchoł M, Krauss H, Wojciechowska M et al (2014) The role of ghrelin, leptin and insulin in foetal development. Ann Agri Env Med 21(2):349–352

    Article  CAS  Google Scholar 

  • West DB, Greenwood MR, Marshall KA, Woods SC (1987) Lithium chloride, cholecystokinin and meal patterns: evidence that cholecystokinin suppresses meal size in rats without causing malaise. Appetite 8:221–227

    Article  CAS  PubMed  Google Scholar 

  • Whatmore AJ, Hall CM, Jones J et al (2003) Ghrelin concentrations in healthy children and adolescents. Clin Endocrinol 59:649–654

    Article  CAS  Google Scholar 

  • Wiedmer P, Nogueiras R, Broglio F et al (2007) Ghrelin, obesity and diabetes. Nat Clin Pract Endocrinol Metab 3:705–712

    Article  CAS  PubMed  Google Scholar 

  • Wierup N, Bjorkqvist M, Westrom B et al (2007) Ghrelin and motilin are cosecreted from a prominent endocrine cell population in the small intestine. J Clin Endocrinol Metab 92:3573–3581

    Article  CAS  PubMed  Google Scholar 

  • Wojcicki JM (2012) Peptide YY in children: a review. J Pediatr Endocrinol Metab 25(3–4):227–232

    CAS  PubMed  Google Scholar 

  • Woods SC (2004) Gastrointestinal satiety signals I. An overview of gastrointestinal signals that influence food intake. Am J Physiol Gastrointest Liver Physiol 286:G7–13

    Article  CAS  PubMed  Google Scholar 

  • Wortley KE, Anderson KD, Garcia K et al (2004) Genetic deletion of ghrelin does not decrease food intake but influences metabolic fuel preference. Proc Natl Acad Sci U S A 101:8227–8232

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Wortley KE, del Rincon JP, Murray JD et al (2005) Absence of ghrelin protects against early-onset obesity. J Clin Invest 115:3573–3578

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Wynne K, Park AJ, Small CJ et al (2006) Oxyntomodulin increases energy expenditure in addition to decreasing energy intake in overweight and obese humans: a randomised controlled trial. Int J Obes(Lond) 30:1729–1736

    Article  CAS  Google Scholar 

  • Xiao Q, Boushey RP, Drucker DJ, Brubaker PL (1999) Secretion of the intestinotropic hormone glucagon-like peptide 2 is differentially regulated by nutrients in humans. Gastroenterology 117:99–105

    Article  CAS  PubMed  Google Scholar 

  • Xiao C, Dash S, Morgantini C et al (2015) Gut peptides are novel regulators of intestinal lipoprotein secretion: experimental and pharmacological manipulation of lipoprotein metabolism. Diabetes 64:2310–2318

    Article  CAS  PubMed  Google Scholar 

  • Yang J, Brown MS, Liang G et al (2008) Identification of the acyltransferase that octanoylates ghrelin, an appetite-stimulating peptide hormone. Cell 132:387–396

    Article  CAS  PubMed  Google Scholar 

  • Yokota I, Kitamura S, Hosoda H et al (2005) Concentration of the n-octanoylated active form of ghrelin in foetal and neonatal circulation. Endocr J 52:271–276

    Article  CAS  PubMed  Google Scholar 

  • Yoshikawa H, Miyata I, Eto Y (2006) Serum glucagon-like peptide-2 levels in neonates: comparison between extremely low-birthweight infants and normal-term infants. Pediatr Int 48:464–469

    Article  CAS  PubMed  Google Scholar 

  • Zhang W, Zhao L, Lin TR et al (2004) Inhibition of adipogenesis by ghrelin. Mol Biol Cell 15:2484–2491

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Zhang JV, Ren PG, Avsian-Kretchmer O et al (2005) Obestatin, a peptide encoded by the ghrelin gene, opposes ghrelin’s effects on food intake. Science 310:996–999

    Article  CAS  PubMed  Google Scholar 

  • Zhang S, Zhai G, Zhang J et al (2014) Ghrelin and obestatin plasma levels and ghrelin/obestatin prepropeptide gene polymorphisms in small for gestational age infants. J Int Med Res 42(6):1232–1242

    Article  PubMed  CAS  Google Scholar 

  • Zou CC, Liang L, Wang CL, Fu JF, Zhao ZY (2009) The change in ghrelin and obestatin levels in obese children after weight reduction. Acta Paediatr 98:159–165

    Article  CAS  PubMed  Google Scholar 

  • Zwirska-Korczala K, Adamczyk-Sowa M, Sowa P et al (2007) Role of leptin, ghrelin, angiotensin II and orexins in 3 T3 L1 preadipocyte cells proliferation and oxidative metabolism. J Physiol Pharmacol 58(Suppl 1):53–64

    PubMed  Google Scholar 

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Prodam, F. et al. (2018). Hormones and Gastrointestinal Function of Newborns. In: Buonocore, G., Bracci, R., Weindling, M. (eds) Neonatology. Springer, Cham. https://doi.org/10.1007/978-3-319-29489-6_184

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