Fasting Serum Total Ghrelin Level Inversely Correlates with Metabolic Syndrome in Hemodialysis Patients

Abstract

Metabolic syndrome (MS) is a significant risk factor for cardiovascular disease and predicts hospitalization in patients undergoing hemodialysis. An inverse association between circulating ghrelin and MS has been observed in adults. However, no data are available on the relationship between MS and serum total ghrelin levels in hemodialysis patients. Fasting blood samples were obtained from 52 hemodialysis patients. MS and its components were defined using diagnostic criteria from the International Diabetes Federation. Total ghrelin levels were measured using a commercial enzyme-linked immunosorbent assay kit. Of the 52 hemodialysis patients, 30 (58%) had MS. Fasting total ghrelin level inversely correlated with MS among these hemodialysis patients (p<0.001). There was a tendency for the fasting total ghrelin level to decrease as the number of diagnostic criteria for MS in patients increased. Univariate linear regression analysis showed that the pre-hemodialysis body weight (r=-0.401; p=0.007), waist circumference (r=-0.554; p<0.001), triglyceride level (r=-0.317; p=0.022), and insulin level (r=-0.353; p=0.015) were negatively correlated with total ghrelin levels, whereas high-density lipoprotein (HDL) (r=0.506; p<0.001) and growth hormone (r=0.305; p<0.040) levels were positively correlated with the total ghrelin level. Multivariate forward stepwise linear regression analysis of the significant variables showed that waist circumference (R(2) change=0.297, p<0.001) was an independent predictor of the total ghrelin among the hemodialysis patients and explained 29.7% of the variance. We observed an inverse association between the circulating fasting total ghrelin level and MS among hemodialysis patients. There was a tendency for the total ghrelin level to decrease as the number of diagnostic criteria for MS in patients increased. Waist circumference was an independent predictor of the total ghrelin level among hemodialysis patients.