The role of «hunger hormone» in the regulation of eating behavior in patients with Parkinson’s disease

Abstract

Objective — to evaluate the correlation between ghrelin levels, body mass index and the course of the disease in patients with Parkinson’s disease Methods and subjects. We examined 40 patients with Parkinson’s disease and 20 patients without signs of neurodegenerative disease (control group), who were examined and admitted to the neurological department. Patients were distributed into groups: 1 group — 20 patients with a disease duration of 12.1 ± 2.3 years, group 2 — 20 patients with a disease duration of 7.3 ± 1.6 years, group 3 — control, 20 patients without signs of morbidity. The diagnosis was made according to the criteria of the World Brain Bank of Great Britain. The severity of the disease was determined by the Hen and Yar scale. All patients, after signing the consent agreement, underwent a general clinical, neurological examination with assessment of anthropometric parameters: height, weight, body mass index. Also, patients underwent laboratory determination of serum ghrelin levels using the method of enzyme‑linked immunosorbent assay (ELISA) on the basis of the Research Institute of Genetic, Immunological Basis of Pathology and Pharmacogenetics of the Ukrainian Medical Dental Academy. Results. Studies indicate that in the group of patients with a longer course of the disease (group 1) there was an increase in BMI, which can be interpreted as obesity or overweight, compared with group 2 and control, where the rate was normal. In group 2, where the duration of the disease was shorter, there was a decrease in BMI, accompanied by weight loss of patients. In each group of examined patients there were patients with different forms of the disease, but in the second group patients with akinetic‑rigid form of the disease prevailed, so these patients in neurological status suffered more from stiffness, immobility. Normally, ghrelin level rises in the morning during hunger and decreases after eating. A similar picture was observed in the control group of patients, where the rate of morning ghrelin was elevated. When assessing fasting plasma ghrelin levels in groups of patients, there is a slight decrease in the indicator compared with the control group. Conclusions. There is a clear correlation between the duration of the disease, body mass index and hunger hormone levels in patients with Parkinson’s disease. In patients with the initial stages of the disease there is a decrease in body mass index, which is a prognostically unfavorable sign. Fluctuations in ghrelin levels may be associated with decreased energy intake due to gastrointestinal dysfunction, increased energy expenditure caused by motor manifestations of the disease, or increased glucose metabolism with the use of drugs and changes in the eating behavior of patients.