The hypothalamic ventromedial nucleus (VMH) is considered the 'satiety center.' Which neuroendocrine signal acts DIRECTLY on VMH neurons to enhance satiety signaling after a meal?

• A Ghrelin from gastric fundus cells activating VMH neurons
• B Leptin from adipose tissue acting on VMH leptin receptors to increase POMC/CART signaling ✓
• C Neuropeptide Y from the lateral hypothalamic area stimulating VMH satiety neurons
• D Cortisol from the adrenal cortex increasing VMH metabolic activity

Explanation

Leptin, secreted proportionally to fat mass, crosses the blood-brain barrier and acts on VMH neurons (and arcuate POMC/CART neurons) to signal satiety and suppress appetite. It also acts on arcuate AgRP/NPY neurons to inhibit hunger signaling. Ghrelin (option A) is an orexigenic hormone that stimulates hunger, not satiety. NPY (option C) is orexigenic and originates from the arcuate nucleus, not lateral hypothalamus. Cortisol (option D) promotes appetite and is not a direct VMH satiety signal.

Reference: Guyton & Hall, Textbook of Medical Physiology, 14th ed.

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