Background: Previous studies have suggested a possible influence of ghrelin on foetal growth. After birth, the regulation of this newly discovered orexigenic peptide is largely unknown.

Objective: To study the relationship between circulating levels of ghrelin and enteral nutritional state in preterm infants during the first months of life.

Methods: Ghrelin levels were measured in a cross-sectional study by radioimmunoassay on the second day after birth (n = 51), at 3 months (n = 63) and at 6 months (n = 53) of corrected postnatal age. Complete data sets of auxological parameters, biochemical values, perinatal diseases, nutritional management and therapy were determined.

Results: All infants showed levels of ghrelin in postnatal serum. In correlation analyses and multivariable linear regression models, ghrelin was strongly related to enteral caloric intake on the second day after birth (all P < 0.01). At 6 months of corrected postnatal age, infants who were exclusively breastfed/formula fed had significantly lower ghrelin levels than infants with solid foods (Mann-Whitney U-test: P = 0.027).

Conclusion: Ghrelin levels were positively correlated with the enteral nutritional state in preterm infants on the second day after birth. The introduction of solid foods increased the ghrelin levels in a group of preterm infants at 6 months of corrected postnatal age.

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