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Meta-Analysis
. 2021 Feb 27;13(3):784.
doi: 10.3390/nu13030784.

Ghrelin as a Biomarker of Stress: A Systematic Review and Meta-Analysis

Jean-Baptiste Bouillon-Minois  1   2 , Marion Trousselard  3 , David Thivel  4 , Brett Ashley Gordon  5 , Jeannot Schmidt  1   2 , Farès Moustafa  6 , Charlotte Oris  7   8 , Frédéric Dutheil  1   9
Affiliations
Meta-Analysis

Ghrelin as a Biomarker of Stress: A Systematic Review and Meta-Analysis

Jean-Baptiste Bouillon-Minois et al. Nutrients. .

Abstract

Introduction: Ghrelin is an orexigenic hormone which favors food-seeking behavior and has been postulated to be a biomarker of stress. We conducted a systematic review and meta-analysis on the evolution of ghrelin levels following acute stress.

Methods: The PubMed, Cochrane Library, Embase, and ScienceDirect databases were searched for studies reporting ghrelin levels before and after acute stress in humans.

Results: We included ten studies for a total of 348 patients. Acute stress (intervention) was always in a laboratory. Acute stress was psychological (Trier Social Stress Test), physical, or mixed (cold pressure test). The overall meta-analysis demonstrated an increase in ghrelin after the stress intervention (ES = 0.21, 95CI 0.09 to 0.34) compared with baseline levels. Stratification by time demonstrated an acute increase in ghrelin levels in the five minutes immediately following the initiation of stress (0.29, 0.10 to 0.48) but without any difference after. Obese individuals had a more significant (ES = 0.51, 95CI 0.18 to 0.84) and prolonged increase in ghrelin levels for up to 45 min compared with non-obese individuals who had a significant increase only five minutes after stress. Moreover, the ghrelin levels increased in response to stress with BMI (coefficient 0.028, 0.01 to 0.49; p = 0.013) and decreased with the time after the stress intervention (coefficient -0.007, -0.014 to -0.001; p = 0.025).

Conclusion: Ghrelin is a biomarker of stress, with a short-term increase following acute stress. Obese individuals have both a higher and prolonged response, emphasizing the link between obesity and stress.

Keywords: anxiety; appetite; mental health; metabolism; public health.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Search strategy.
Figure 2
Figure 2
Methodological quality of included articles using the Newcastle–Ottawa Quality Assessment Scale. Yes: +; no: -; cannot say: ?; not applicable: NA.
Figure 3
Figure 3
Meta-analysis of ghrelin levels following acute stress compared to baseline levels, stratified by time after the initiation of the acute stress intervention.
Figure 4
Figure 4
Meta-analysis of ghrelin levels after acute stress compared to baseline levels in the normal-weight population, stratified by time after the initiation of the acute stress intervention.
Figure 5
Figure 5
Meta-analysis of ghrelin levels after acute stress compared to baseline levels in the overweight population, stratified by time after the initiation of the acute stress intervention.
Figure 6
Figure 6
Meta-regressions—i.e., factors influencing changes in ghrelin levels following acute stress. Each variable’s effect on the outcome is represented in the forest-plot by a dot on a horizontal line. The circles represent the coefficient for each variable, and the length of each line around the dots represents their 95% confidence interval (95CI). The black solid vertical line represents the null estimate (with a value of 0). Horizontal lines that cross the null vertical line represent non-significant variables on the outcome. Bold p-value are significant.
Figure 7
Figure 7
Metafunnel and meta-analysis of ghrelin levels after acute stress compared to baseline levels after exclusion from the metafunnel, stratified by time after the initiation of the acute stress intervention.
See this image and copyright information in PMC

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