Serum ghrelin levels are suppressed in hypopituitary patients following insulin‐induced hypoglycaemia irrespective of GH status
Bibliographic record
Abstract
OBJECTIVE: Circulating ghrelin is suppressed during insulin-induced hypoglycaemia in healthy subjects, but it is unknown whether this is determined by feedback inhibition from counter-regulatory hormones. We therefore investigated the impact of GH and cortisol on ghrelin secretion during insulin-induced hypoglycaemia. DESIGN: Serum levels of ghrelin, GH, and cortisol were measured in 41 adult patients with suspected hypopituitarism during insulin-induced hypoglycaemia. Based on their peak GH response (cut-off level: 3 microg/l), the patients were divided into a GH-sufficient group (GHS) and a GH-deficient group (GHD). RESULTS: The GHS patients (n = 16) were younger (P < 0.01), had lower baseline cortisol levels [255 +/- 37 vs. 372 +/- 38 nmol/l (P = 0.04)], and tended to have a lower body mass index (P = 0.09) as compared to GHD patients (n = 25). By definition, peak GH (microg/l) was higher in GHS patients [15.0 +/- 1.8 vs. 1.0 +/- 0.2 (P < 0.0001)]. The increase in serum cortisol during the ITT (insulin-tolerance test) was higher and occurred later in GHS patients [Cmax (nmol/l): 561 +/- 41 vs. 412 +/- 50 (P = 0.04); Tmax (minutes): 65 +/- 5 vs. 49 +/- 5 (P = 0.03)]. Serum ghrelin levels changed significantly with time during ITT in both groups (P < 0.0001), characterized by a moderate decline during the initial 50-60 min and a return to baseline after 2 h. No significant differences were recorded in AUCghrelin during the ITT between the two groups. No gender differences in ghrelin levels were recorded. CONCLUSIONS: (i) Like in healthy subjects serum ghrelin levels are suppressed during an ITT in patients with suspected hypopituitarism. (ii) The suppression of ghrelin was similar in GHD and GHS subjects and was not determined by cortisol. (iii) We hypothesize that insulin rather than hypoglycaemia accounts for ghrelin suppression during an ITT.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".