Tu1206 Dyspeptic Symptoms in Inflammatory Bowel Diseases (IBD) Are Associated With Prolonged Gastric Emptying and High Serum Leptin Levels

Abstract

Background: Symptoms compatible with GI functional disorders are higher in patients with IBD compared with controls. We demonstrated that delayed gastric emptying was associated with dyspeptic symptoms in inactive Crohn's disease. Serum ghrelin and leptin levels were elevated in IBD patients and it was described that these hormones couldmodify the gastrintestinal motility. High ghrelin or leptin serum concentrations are associated with symptoms in functional dyspepsia. The relationship between ghrelin and leptin with GI symptoms and gastric motility in IBD patients has not been studied. Aim: To investigate the relationship between dyspeptic symptoms, gastric emptying, serum levels of ghrelin and leptin in IBD. Methods: Twenty seven patients with IBD (14 with Crohn's disease and 13 with ulcerative colitis) underwent a gastric emptying test by breath test using 13C octanoic acid coupled to a solid meal and answered a validated questionnaire (PADYQ, The Porto Alegre Dyspeptic Symptoms Questionnaire) to assess dyspeptic symptoms; fasting blood samples were also collected to measure active ghrelin or leptin by a RIA. Then, IBD patients were allocated in two groups according to their total PADYQ score: non-dyspeptic (score=0), dyspeptic (score > 0). Control group was composed by 26 sex-matched healthy volunteers. The study was approved by the local Ethical Committee (049.07.08). Results: IBD patients had a significantly (p<0.01) slower gastric emptying (t1⁄2= 243.9 ± 14.2 min) than the controls (t1⁄2= 174.1 ± 6.3 min). IBD patients with dyspepsia (t1⁄2=265.9 ± 21.7 min, N=14) had significantly (p<0.05) prolonged gastric emptying when compared to IBD patients without dyspeptic symptoms (t1⁄2= 220.2 ± 16.1 min, N=13). Leptin (25.9 ± 5.8 ng/ml), but not active ghrelin (28.5 ± 2.4 pg/ml), was significantly (p<0.05) higher in IBD patients with dyspepsia than in IBD patients without dyspepsia (leptin= 13.7 ± 3.4 ng/ml, ghrelin=33.2 ± 6.0 pg/ml). In IBD patients with dyspepsia, only vomiting had positive linear correlation with gastric emptying (t1⁄2) (p=0.03) and leptin levels (p=0.06). No difference between the subgroups of patients with respect to type of disease (Crohn or ulcerative colitis), gender or age was found. However, the group with dyspepsia had more patients with active diseases than the group without dyspepsia (p<0.01). Conclusion: In IBD patients, dyspeptic symptoms, particularly vomiting, were associated with prolonged gastric emptying, high leptin serum levels and the presence of disease activity. The clinical relevance of the present findings remains to be demonstrated. Financial support: Capes, CNPq.