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Active ghrelin and the postpartum

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Abstract

Postpartum depression (PPD) occurs in 10–15 % of women. The appetite hormone ghrelin, which fluctuates during pregnancy, is associated with depression in nonpregnant samples. Here, we examine the association between PPD and active ghrelin from pregnancy to postpartum. We additionally examine whether ghrelin changes from pregnancy to postpartum and differs between breastfeeding and non-breastfeeding women. Sixty women who participated in a survey examining PPD and had information in regard to ghrelin concentrations were included in the study. The Edinburgh Postnatal Depression Scale was used to assess symptoms of PPD. Raw ghrelin levels and ghrelin levels adjusted for creatinine were included as outcomes. Women screening positive for PPD at 12 weeks postpartum had higher pregnancy ghrelin concentrations. Ghrelin concentrations significantly decreased from pregnancy to 6 weeks postpartum and this change differed based on pregnancy depression status. Finally, ghrelin levels were lower in women who breastfed compared with women who were bottle-feeding. No significant findings remained once ghrelin levels were adjusted for creatinine. Although results do not suggest an association between PPD and ghrelin after adjusting for creatinine, future research should continue to explore this possibility extending further across the postpartum period with larger sample sizes.

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References

  • Angelidis G, Dafopoulos K, Messini CI, Valotassiou V, Georgoulias P, Messinis IE (2012) Ghrelin: new insights into female reproductive system-associated disorders and pregnancy. Reprod Sci 19:903–910

    Article  PubMed  Google Scholar 

  • Aydin S, Karatas F, Geckil H (2008) Simultaneous quantification of acylated and desacylated ghrelin in biological fluids. Biomed Chromatogr 22:1354–1359

    Article  CAS  PubMed  Google Scholar 

  • Aydin S, Ozkan Y, Kumru S (2006) Ghrelin is present in human colostrum, transitional and mature milk. Peptides 27:878–882

    Article  CAS  PubMed  Google Scholar 

  • Baker JL, Gamborg M, Heitmann BL, Lissner L, Sorensen TI, Rasmussen KM (2008) Breastfeeding reduces postpartum weight retention. Am J Clin Nutr 88:1543–1551

    Article  CAS  PubMed  Google Scholar 

  • Barim AO, Aydin S, Colak R, Dag E, Deniz O, Sahin I (2009) Ghrelin, paraoxonase and arylesterase levels in depressive patients before and after citalopram treatment. Clin Biochem 42:1076–1081

    Article  CAS  PubMed  Google Scholar 

  • Baykus Y et al (2012) Changes in serum obestatin, preptin and ghrelins in patients with gestational diabetes mellitus. Clin Biochem 45:198–202

    Article  CAS  PubMed  Google Scholar 

  • Bloch M, Daly RC, Rubinow DR (2003) Endocrine factors in the etiology of postpartum depression. Compr Psychiatry 44:234–246

    Article  PubMed  Google Scholar 

  • Chuang JC, Zigman JM (2010) Ghrelin’s roles in stress, mood, and anxiety regulation Int J Pept 2010;2010

  • Cohen LS, Soares CN, Vitonis AF, Otto MW, Harlow BL (2006) Risk for new onset of depression during the menopausal transition: the Harvard study of moods and cycles. Arch Gen Psychiatry 63:385–390

    Article  PubMed  Google Scholar 

  • Cox JL, Holden JM, Sagovsky R (1987) Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry 150:782–786

    Article  CAS  PubMed  Google Scholar 

  • Cummings DE, Purnell JQ, Frayo RS, Schmidova K, Wisse BE, Weigle DS (2001) A preprandial rise in plasma ghrelin levels suggests a role in meal initiation in humans. Diabetes 50:1714–1719

    Article  CAS  PubMed  Google Scholar 

  • Dzaja A, Dalal MA, Himmerich H, Uhr M, Pollmacher T, Schuld A (2004) Sleep enhances nocturnal plasma ghrelin levels in healthy subjects. Am J Physiol Endocrinol Metab 286:E963–967

    Article  CAS  PubMed  Google Scholar 

  • Field T (2010) Postpartum depression effects on early interactions, parenting, and safety practices: a review. Infant Behav Dev 33:1–6

    Article  PubMed  PubMed Central  Google Scholar 

  • Flores DL, Hendrick VC (2002) Etiology and treatment of postpartum depression. Curr Psychiatry Rep 4:461–466

    Article  PubMed  Google Scholar 

  • Fuglsang J, Skjaerbaek C, Espelund U, Frystyk J, Fisker S, Flyvbjerg A, Ovesen P (2005) Ghrelin and its relationship to growth hormones during normal pregnancy. Clin Endocrinol 62:554–559

    Article  CAS  Google Scholar 

  • Garcia-Esteve L, Ascaso C, Ojuel J, Navarro P (2003) Validation of the Edinburgh Postnatal Depression Scale (EPDS) in Spanish mothers. J Affect Disord 75:71–76

    Article  PubMed  Google Scholar 

  • Gaynes BN et al. (2005) Perinatal depression: prevalence, screening accuracy, and screening outcomes Evid Rep Technol Assess (Summ):1–8

  • 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 

  • Kellokoski E, Poykko SM, Karjalainen AH, Ukkola O, Heikkinen J, Kesaniemi YA, Horkko S (2005) Estrogen replacement therapy increases plasma ghrelin levels. J Clin Endocrinol Metab 90:2954–2963

    Article  CAS  PubMed  Google Scholar 

  • Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE (2005) Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 62:593–602

    Article  PubMed  Google Scholar 

  • Kessler RC et al (1994) Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States: results from the National Comorbidity Survey. Arch Gen Psychiatry 51:8–19

    Article  CAS  PubMed  Google Scholar 

  • Kluge M, Schussler P, Dresler M, Schmidt D, Yassouridis A, Uhr M, Steiger A (2011) Effects of ghrelin on psychopathology, sleep and secretion of cortisol and growth hormone in patients with major depression. J Psychiatr Res 45:421–426

    Article  PubMed  Google Scholar 

  • Larson-Meyer DE, Ravussin E, Heilbronn L, DeJonge L (2010) Ghrelin and peptide YY in postpartum lactating and nonlactating women. Am J Clin Nutr 91:366–372

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Lutter M et al (2008) The orexigenic hormone ghrelin defends against depressive symptoms of chronic stress. Nat Neurosci 11:752–753

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Matthey S, Henshaw C, Elliott S, Barnett B (2006) Variability in use of cut-off scores and formats on the Edinburgh Postnatal Depression Scale: implications for clinical and research practice. Arch Womens Ment Health 9:309–315

    Article  CAS  PubMed  Google Scholar 

  • McNeilly AS, Tay CC, Glasier A (1994) Physiological mechanisms underlying lactational amenorrhea. Ann N Y Acad Sci 709:145–155

    Article  CAS  PubMed  Google Scholar 

  • Murray L, Carothers AD (1990) The validation of the Edinburgh Post-natal Depression Scale on a community sample. Br J Psychiatry 157:288–290

    Article  CAS  PubMed  Google Scholar 

  • Nakashima K et al (2008) Ghrelin gene polymorphism is associated with depression, but not panic disorder. Psychiatr Genet 18:257

    Article  PubMed  Google Scholar 

  • Nolen-Hoeksema S, Girgus JS (1994) The emergence of gender differences in depression during adolescence. Psychol Bull 115:424–443

    Article  CAS  PubMed  Google Scholar 

  • Olson CM, Strawderman MS, Hinton PS, Pearson TA (2003) Gestational weight gain and postpartum behaviors associated with weight change from early pregnancy to 1 y postpartum. Int J Obes 27:117–127

    Article  CAS  Google Scholar 

  • Palik E, Baranyi E, Melczer Z, Audikovszky M, Szocs A, Winkler G, Cseh K (2007) Elevated serum acylated (biologically active) ghrelin and resistin levels associate with pregnancy-induced weight gain and insulin resistance. Diabetes Res Clin Pract 76:351–357

    Article  CAS  PubMed  Google Scholar 

  • Pearlstein T, Howard M, Salisbury A, Zlotnick C (2009) Postpartum depression. Am J Obstet Gynecol 200:357–364

    Article  PubMed  PubMed Central  Google Scholar 

  • Sakata I, Tanaka T, Yamazaki M, Tanizaki T, Zheng Z, Sakai T (2006) Gastric estrogen directly induces ghrelin expression and production in the rat stomach. J Endocrinol 190:749–757

    Article  CAS  PubMed  Google Scholar 

  • Schmid DA, Held K, Ising M, Uhr M, Weikel JC, Steiger A (2005) Ghrelin stimulates appetite, imagination of food, GH, ACTH, and cortisol, but does not affect leptin in normal controls. Neuropsychopharmacology 30:1187–1192

    Article  CAS  PubMed  Google Scholar 

  • Schmid SM, Hallschmid M, Jauch-Chara K, Born J, Schultes B (2008) A single night of sleep deprivation increases ghrelin levels and feelings of hunger in normal-weight healthy men. J Sleep Res 17:331–334

    Article  PubMed  Google Scholar 

  • Schmidt PJ, Haq N, Rubinow DR (2004) A longitudinal evaluation of the relationship between reproductive status and mood in perimenopausal women. Am J Psychiatry 161:2238–2244

    Article  PubMed  Google Scholar 

  • Shibata K et al (2004) Regulation of ghrelin secretion during pregnancy and lactation in the rat: possible involvement of hypothalamus. Peptides 25:279–287

    Article  CAS  PubMed  Google Scholar 

  • Spiegel K, Tasali E, Penev P, Van Cauter E (2004) Brief communication: sleep curtailment in healthy young men is associated with decreased leptin levels, elevated ghrelin levels, and increased hunger and appetite. Ann Intern Med 141:846–850

    Article  PubMed  Google Scholar 

  • Steiger A, Dresler M, Schussler P, Kluge M (2011) Ghrelin in mental health, sleep, memory. Mol Cell Endocrinol 340:88–96

    Article  CAS  PubMed  Google Scholar 

  • Stuebe AM, Mantzoros C, Kleinman K, Gillman MW, Rifas-Shiman S, Gunderson EP, Rich-Edwards J (2011) Duration of lactation and maternal adipokines at 3 years postpartum. Diabetes 60:1277–1285

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Sun Y, Butte NF, Garcia JM, Smith RG (2008) Characterization of adult ghrelin and ghrelin receptor knockout mice under positive and negative energy balance. Endocrinology 149:843–850

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Szentirmai E, Kapas L, Krueger JM (2007) Ghrelin microinjection into forebrain sites induces wakefulness and feeding in rats. Am J Physiol Regul Integr Comp Physiol 292:R575–585

    Article  CAS  PubMed  Google Scholar 

  • Wang WG, Chen X, Jiang H, Jiang ZY (2008) Effects of ghrelin on glucose-sensing and gastric distension sensitive neurons in rat dorsal vagal complex. Regul Pept 146:169–175

    Article  CAS  PubMed  Google Scholar 

Download references

Compliance with ethical standards

Ethics approval

The study was approved by the University of North Carolina Biomedical Institutional Review Board as well as the Wake County Human Services Board and conducted in accordance with The Code of Ethics of the World Medical Association.

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The authors declare that they have no competing interests.

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Correspondence to Kimberly A. Brownley.

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Baker, J.H., Pedersen, C., Leserman, J. et al. Active ghrelin and the postpartum. Arch Womens Ment Health 19, 515–520 (2016). https://doi.org/10.1007/s00737-015-0578-0

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  • DOI: https://doi.org/10.1007/s00737-015-0578-0

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