Ghrelin Levels in Children With Poor Growth
Ghrelin Levels in Children With Poor Growth
The investigators hypothesize that low serum ghrelin levels may characterize a group of
 patients with poor weight gain and/or linear growth who do not have any other identified
 cause for growth failure. These patients may present with a variety of complaints and are
 often evaluated by both pediatric endocrinologists and pediatric gastroenterologists. The
 investigators hypothesize that ghrelin has a physiologically important role in linear growth
 and that chronic diseases of the gastrointestinal system, such as H. Pylori infection or
 celiac disease, may alter serum ghrelin levels in children. Low ghrelin levels may be a
 factor leading to poor growth, potentially by altering growth hormone secretion and/or by
 decreasing appetite. By measuring ghrelin levels in children with short stature and in
 children with gastrointestinal disease, the investigators will further elucidate the possible
 physiologic role of ghrelin in childhood growth and how it may be altered in conditions
 causing short stature and in certain gastrointestinal diseases.
Inclusion Criteria:

 -  To be included in the short stature group, subjects must have had short stature,
 defined height less than -2 SD for gender and age or an abnormal growth velocity for
 gender and age).

 -  To be included in the failure-to-thrive group, subjects must have had poor weight
 gain, defined as weight less than -2 SD for gender and age or an abnormal weight
 velocity for gender and age.

 -  Patients in both groups will be evaluated for the presence of chronic gastrointestinal
 symptoms, defined as symptoms of gastrointestinal disease for greater than 6 weeks or
 recurrent symptoms. Patients who were affected in both weight and height will be
 stratified by which measurement was more severely affected, with poor weight gain
 being the primary problem in the "failure-to-thrive" grouping (Group 2) and "poor
 linear growth" being the primary problem in the short stature group (Group 1).

 -  Patients who have had chronic gastrointestinal symptoms, defined as symptoms of
 gastrointestinal disease for greater than 6 weeks or recurrent symptoms, but normal
 stature and growth, will be analyzed separately (Group 3).

 Exclusion Criteria:

 -  Must not have a known diagnosis as an etiology for growth failure or GI symptoms prior
 to presentation.