Elevated plasma ghrelin levels in night eating syndrome

Night eating syndrome (NES) is a rare syndrome that includes disturbances of both eating and sleeping. It is characterized by awakening in the middle of the night, getting out of bed and consuming large quantities of food, then returning to sleep. The NES is associated with depression, elevated serum levels of cortisol, and blunting of the usual nighttime increase of the levels of melatonin and leptin. Ghrelin is an endogenous ligand of the growth hormone (GH) secretagogue (GHS) receptor, stimulates GH release, appetite, and weight gain in humans and rodents. We examined nocturnal secretion of plasma ghrelin and other hormones of a 27 year old female patient between 2200 and 0700 and polysomnographic recordings were obtained from 2300 to 0700. Ghrelin plasma concentrations and other hormornes were measured before treatment with a SSRI, during remission under a SSRI and after finishing treatment. Plasma ghrelin levels of our patient were about threefold higher compared to average ghrelin levels of healthy young women. No significant change of the elevated ghrelin plasma concentration was observed after successful treatment with the selective serotonin reuptake inhibitor citalopram. Other hormones tested like cortisol, ACTH, leptin and GH were in the normal range, during all stages of the illness and after remission. Ghrelin might be a keyplayer in the aetiology of this syndrome because of its known capacity to stimulate appetite.