Plasma Ghrelin Levels In Patients Research Articles

Зміна концентрації греліну при цукровому діабеті 2-го типу, асоційованому з ожирінням, після лапароскопічної рукавної резекції шлунка

Laparoscopic sleeve gastrectomy (LSG) is an effective method of treating obesity complicated by type 2 diabetes mellitus (T2DM). The performance of this metabolic surgical intervention involves removal fundus of the stomach, which in turn leads to an effect on the eating behavior of patients in the form of a decrease in appetite and loss of excess body weight with a parallel effect on the compensation of T2DM in the postoperative period, regardless of the loss of body weight. At present, mechanisms of T2DM compensation after LSG have not yet been clearly defined. The aim of our study was to study the effect of LSG on the dynamics of changes in the blood plasma ghrelin levels in patients with T2DM associated with obesity. The plasma ghrelin levels were assessed in the fasted state, 15, 30, 60, and 90 min after a standard breakfast carbohydrate preload, which included 125 ml of Nutricia Nutridrink, a balanced high-energy protein. The examination was carried out before the operation, on the 4th postoperative day and 3 months after the operation. 7 patients were diagnosed with T2DM for the first time, 3 had a history of diabetes for 2 years, one patient had a history of 3.5 years, and another had a history of 10 years. The average content of glycated hemoglobin before the operation was 7.7%, 3 months after LSG - 5.9%. The fasting ghrelin concentration before LSG performing was 6.8 ng/ml, on the 4th postoperative day – 4.6 ng/ml, and 3 months after the operation – 4.4 ng/ml (P = 0.001) in comparison with preoperative indicators). The peak insulin concentration was noted 30 min after the carbohydrate preload 3 months after the operation and was 175.1 μU/ml, and its fasting levels in the postoperative period reached a statistically significant difference compared to the preoperative values (30 μU/ml before surgery and 25.3 μU/ml 3 months after LSG). Thus, LSG leads to an early and significant suppression of fasting ghrelin secretion in patients with obesity-associated T2DM and likely to restore insulin secretion and/or reduce insulin resistance. Rapid postoperative improvement of carbohydrate metabolism components indicates the importance of the early reduction of ghrelin secretion in combination with the incretin effect of LSG in the implementation of the mechanisms of early compensation of T2DM and explains the metabolic activity of this operation and the significant role of the stomach in the regulation of glucose metabolism.

Changes in total and acylated ghrelin levels during mitotane treatment in patients with adrenocortical carcinoma.

Adrenocortical carcinoma (ACC) is a highly aggressive cancer with poor prognosis. Mitotane is the only approved drug for ACC treatment. Tolerability and efficacy of mitotane is variable. There is evidence that ghrelin may affect cancer development and the occurrence of side effects. We examined the differences in plasma ghrelin concentrations between patients with benign adrenal tumors and adrenal carcinoma. We also investigated the effect of mitotane treatment on circulating plasma ghrelin levels in patients with ACC. Additionally, we assessed the relationship between ghrelin concentrations, mitotane levels, and side effects of mitotane treatment. We enrolled 26 patients with ACC and 42 controls with adrenocortical adenoma (ACA). Clinical and histopathologic features, hormonal secretion pattern, and plasma acylated and total ghrelin levels were measured in every patient. Serum mitotane levels, body mass index, and side effects of mitotane treatment were estimated every 3 to 12 weeks during follow‑up in patients with ACC. There was no significant difference in total and acylated ghrelin concentrations between ACC and ACA groups before mitotane introduction in ACC. We observed that during mitotane treatment, both total and acylated ghrelin levels became elevated in ACC compared with ACA. A positive correlation was found between circulating mitotane levels and acylated ghrelin as well as the ratio of acylated to total ghrelin levels in all patients treated with mitotane. Higher ghrelin levels were associated with increased risk of side effects. Plasma ghrelin levels are changed during mitotane treatment. These changes may be connected with side effects of mitotane.

Effect of rivastigmine on plasma butyrylcholine esterase activity and plasma ghrelin levels in patients with dementia in Alzheimer's disease.

Alzheimer's disease causes loss of appetite, resulting in bodyweight reduction. This, in turn, causes progression of cognitive dysfunction and physical complications that hasten death. Earlier care for loss of appetite is essential in Alzheimer's disease management. Rivastigmine is a therapeutic agent for Alzheimer's disease that has dual inhibition effects on acetylcholine esterase and butyrylcholine esterase. Butyrylcholine esterase is known to degrade the gastric hormone, ghrelin, which regulates appetite; therefore, we considered that rivastigmine might have an effect on appetite. The present study aimed to evaluate the hypothesis that rivastigmine improves appetite in Alzheimer's disease patients. Rivastigmine was given to mild-to-moderate Alzheimer's disease patients for 16 weeks. We evaluated the effects of rivastigmine on food intake, bodyweight, motivation (estimated by the vitality index), cognition function (estimated by the Hasegawa Dementia Scale-Revised), plasma butyrylcholine esterase activity, active ghrelin and inactive ghrelin. Plasma butyrylcholine esterase activity significantly decreased over time (percent change: -18.9 ± 27.0%, P < 0.05 at week 8; percent change: -33.4 ± 45.4%, P < 0.05 at week 16). Negative correlations were detected between percent changes in butyrylcholine esterase activity and active ghrelin (rs = -0.62, P = 0.033) or active/inactive ghrelin ratio (rs = -0.73, P = 0.007). Furthermore, motivation (including appetite) improved significantly (percent change: 17.9 ± 18.6%, P < 0.05 at week 16). The present study suggests that rivastigmine might improve appetite in mild-to-moderate Alzheimer's disease patients by suppressing degradation of plasma active ghrelin through the inhibition of plasma butyrylcholine esterase. Geriatr Gerontol Int 2018; 18: 886-891.

Hyperprolactinemia has no effect on plasma ghrelin levels in patients with prolactinoma.

Accumulating evidence suggests that prolactin is a modulator of body weight and composition and that it regulates some transporters in adipose tissue. It was demonstrated that hyperprolactinemia is associated with weight gain and obesity. Ghrelin is a novel hormone secreted from many organs including the pituitary gland. Ghrelin acts by regulating energy homeostasis and stimulating appetite. The aim of this study is to investigate whether ghrelin has a role in the case of weight gain in patients with prolactinoma. Forty-four patients with prolactinoma, both newly diagnosed and undergoing cabergoline treatment, were included in this study. Age- and sex-matched healthy subjects were included in the control group. Serum fasting glucose, insulin, lipid profile, and ghrelin levels were measured. Homeostasis model assessment of insulin resistance (HOMA-IR) was also calculated. Body mass index (BMI) and total fat ratio (%) of all the participants were assessed by bioelectrical impedance analysis using TBF-310GS™ (Tanita Corporation, Tokyo, Japan). Patients with prolactinoma demonstrated significantly higher serum levels of fasting insulin, triglyceride, and waist and hip circumference measurement. No significant difference was found between the fasting glucose, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and HOMA-IR levels. BMI was significantly higher in the patients with prolactinoma than that in the control group (p<0.05). Additionally, the total body fat percentage was higher in the patients with prolactinoma than that in the control group; however, the difference was not significant (p>0.05). Furthermore, there was no significant difference in terms of the ghrelin levels between these groups. There was a correlation with serum ghrelin and growth hormone levels (p<0.02, rho=0.489). However, no significant correlation was obtained between serum prolactin or ghrelin levels and body fat percentage. According to the results of our study, ghrelin has no effect on weight gain in patients with prolactinoma. Further studies are needed to evaluate whether ghrelin affects the prevalence of obesity in patients with prolactinoma.

Characterization of pericardial and plasma ghrelin levels in patients with ischemic and non-ischemic heart disease

Ghrelin is an endocrine regulatory peptide with multiple functions including cardioprotective effects. It is produced in various tissues among others in the myocardium. Pericardial fluid has been proven to be a biologically active compartment of the heart that communicates with the myocardial interstitium. Thus, pericardial level of certain agents may reflect their concentration in the myocardium well. In our study we measured acylated (active) and total (acylated and non-acylated) pericardial and plasma ghrelin levels of patients with ischemic and non-ischemic heart disease. Pericardial fluid and plasma samples were obtained from patients with coronary artery disease (ISCH, n=54) or valvular heart disease (VHD, n=41) undergoing cardiac surgery. Acylated pericardial ghrelin concentrations were found to be significantly higher in patients with ischemic heart disease (ISCH vs. VHD, 32±3 vs. 16±2pg/ml, p<0.01), whereas plasma levels of the peptide showed no difference between patient groups. Pericardial-to-plasma ratio, an index abolishing systemic effects on local ghrelin level was also significantly higher in ISCH group for both acylated and total ghrelin. Plasma total ghrelin showed negative correlation to BMI, plasma insulin and insulin resistance index HOMA-A. Pericardial acylated and total ghrelin concentrations were negatively correlated with posterior wall thickness (R=−0.31, p<0.05 and R=−0.35, p<0.01, respectively). Plasma insulin concentration and HOMA-A showed significant negative correlation with pericardial ghrelin levels. In conclusion, increased pericardial active ghrelin content and higher pericardial-to-plasma ghrelin ratio were found in ischemic heart disease as compared to non-ischemic patients suggesting an increased ghrelin production of the chronically ischemic myocardium. According to our results, pericardial ghrelin content is negatively influenced by left ventricular hypertrophy and insulin resistance.

Effects of rikkunshito, a kampo medicine, on quality of life after proximal gastrectomy

BackgroundThe loss of the gastroesophageal junction after proximal gastrectomy (PG) induces various gastrointestinal symptoms, such as regurgitation, anorexia, and body weight loss, leading to impairment of the postoperative quality of life. In the present study, we investigated the long-term quality of life and the effects of rikkunshito, a traditional Japanese medicine (kampo), on the gastrointestinal symptoms and plasma ghrelin levels in patients with gastric cancer who had undergone PG. MethodsNineteen patients who had undergone PG> 6 mo before entry into the present study were enrolled. The plasma ghrelin levels, body weight, appetite, and Gastrointestinal Symptom Rating Scale (GSRS) scores were examined before and after the 4-wk administration of rikkunshito. A subgroup analysis was performed of patients showing a GSRS score of ≥ 2 before treatment, indicating the presence of gastrointestinal symptoms. ResultsThe patients' body weight increased significantly after the administration of rikkunshito. Neither their appetite nor plasma acylated and deacylated ghrelin levels were significantly affected. In the subgroup analysis, the mean total GSRS score improved significantly from 2.6 ± 0.6 before the administration of rikkunshito to 1.9 ± 0.7 after administration because of the significant improvement in the subscale scores for abdominal pain, acid reflux, diarrhea, and constipation. ConclusionsThe long-term quality of life was well preserved in the patients who had undergone PG at our hospital. In the patients with a baseline GSRS score of ≥2, rikkunshito significantly improved the symptoms of postgastrectomy syndrome, and its effect was possibly independent of the plasma ghrelin levels.

AB0396 Plasma ghrelin levels in patients with systemic sclerosis

BackgroundSystemic sclerosis (SSc) is a systemic connective tissue disease characterised by immune system changes, fibrosis of the skin and internal organs involvement and diffuse microangiopathy. Ghrelin, a 28 amino acid...

Ghrelin levels in chronic periodontitis patients

Ghrelin is a peptide hormone that has modulatory effects on the immune system. This study was designed to evaluate plasma ghrelin levels in patients with chronic periodontitis and to investigate if a relationship exists between ghrelin and periodontal parameters, serum cytokines, and bone turnover markers. Thirty-five chronic periodontitis patients (CP) and periodontal healthy individuals (C) were included in this study. Periodontal parameters were recorded. Blood samples were obtained to determine the levels of total and acylated ghrelin, interleukin-1 beta (IL-1β), tumor necrosis factor-alpha (TNF-α), the soluble receptor activator nuclear factor kappaB ligand (sRANKL), alkaline phosphatase (ALP), and osteocalcin (OSC). Plasma levels of total and acylated ghrelin were significantly elevated in the CP group compared with the C group (p < 0.05). The difference was significant only between males in the two groups (groups were compared with respect to gender) (p < 0.05). There was no difference between the groups regarding the levels of serum sRANKL, TNF-α, and ALP. A relative increase in the serum levels of IL-1β and a decrease in the serum levels of OSC of the CP group were observed (p < 0.05). In addition, positive correlations between total ghrelin/ALP and total ghrelin/acylated ghrelin were discovered. We found no direct correlation between ghrelin levels and periodontal parameters. Our results indicate an increase of total and acylated ghrelin levels in patients with chronic periodontitis. Further, studies in larger populations (which could include ghrelin levels in gingival tissue, gingival crevicular fluid, and saliva) are needed in order to confirm the role of ghrelin in periodontal disease.

Neural correlates of plasma acylated ghrelin level in individuals with major depressive disorder

Anhedonic symptoms, which include loss of pleasure, appetite and motivation, are key symptoms of major depressive disorder (MDD) and are thought to depend on a neural circuit of the mesolimbic system. The neuropeptide ghrelin plays a crucial role in appetite and reward. Little is known, however, about the role of ghrelin in MDD. We examined the association between morphometric change and plasma ghrelin levels in patients with MDD. Twenty-four patients with MDD and 24 healthy control subjects were studied. Plasma concentration of acylated ghrelin was measured after a period of fasting. Using voxel-based morphometry, we found a main effect of ghrelin on the volume of several brain regions. We then compared these regional volumes in patients with MDD versus healthy subjects. We also compared brain volumes between the two groups, controlling for ghrelin level. There was no significant difference in plasma acylated ghrelin level between patients with MDD and healthy subjects. In the MDD group, ghrelin levels positively correlated with the severity of reduced appetite. Ghrelin levels negatively correlated with gray matter volume of the ventral tegmental area (VTA) in the total sample. The patients with MDD showed significantly smaller VTA gray matter volume compared to healthy subjects. Controlling for the plasma acylated ghrelin level, patients with MDD showed significantly smaller gray matter volume of right substantia nigra compared to healthy subjects. Our findings suggest that plasma acylated ghrelin is associated with neural abnormalities of the pleasure/reward system and may be involved in the pathophysiology of MDD.

Plasma Ghrelin Levels in Patients with Familial Mediterranean Fever

Familial Mediterranean fever (FMF) is an auto-inflammatory disorder characterized by febrile attacks. Increased acute-phase reactants are characteristic during febrile attacks. Ghrelin is a natural G-protein that decreases secretion of pro-inflammatory cytokines and acts as anti-inflammatory agent. The aim of this study was to investigate whether there is any change in ghrelin levels and whether increases in ghrelin levels can be used as a marker in these patients. Thirty-seven male patients and 30 healthy men as a control group were included in the study. Blood samples were obtained for ghrelin measurements both before the attacks (pre-attack period; ghrelin 1 group) and during the attacks (ghrelin 2 group). Samples were kept at -80°C until the analysis was conducted and plasma ghrelin levels were measured using an immune-sorbent assay method. Mean ghrelin levels measured during the attacks were significantly higher (11.01 ± 4.78 pg/ml) as compared to pre-attack levels (5.78 ± 2.17 pg/ml; p < 0.001). Similarly, mean ghrelin levels measured in FMF patients during an attack were significantly different from that of the control group (6.57 ± 4.13 pg/ml; p < 0.001). In this study, high ghrelin levels were measured during attacks in FMF patients. This finding is in line with previous results regarding the fact that inflammatory response arising during an FMF attack is an acute inflammatory event. Our findings suggest that ghrelin levels measured during FMF attacks could be used as a biochemical indicator for the FMF attack in FMF patients and that it could be used for support of the diagnosis of the disease.

Altered fasting and postprandial plasma ghrelin levels in patients with liver failure are normalized after liver transplantation

Anorexia is a problem of paramount importance in patients with advanced liver failure. Ghrelin has important actions on feeding and weight homeostasis. Experimental data exist, which suggest that ghrelin could protect hepatic tissue. Both fasting and post-oral glucose tolerance test (OGTT) ghrelin concentrations are controversial in liver cirrhosis and are unknown after liver transplantation. Our aim was to study fasting ghrelin concentrations and their response to an OGTT in liver failure patients before and after liver transplantation. We included 21 patients with severe liver failure studied before (pretransplantation, PreT) and 6 months after liver transplantation (posttransplantation, PostT), and 10 age- and body mass index-matched healthy or overweight subjects as the control group (Cont). After an overnight fast, 75 g of oral glucose were administered; glucose, insulin, and ghrelin were obtained at baseline and at times 30, 60, 90, and 120 min. Fasting ghrelin (median and range, pg/ml) levels were lower in PreT: 539 (309-1262) than in Cont: 643 (523-2163), P=0.045. Fasting ghrelin levels increased after liver transplantation, 539 (309-1262) vs 910 (426-3305), for PreT and PostT respectively, P=0.001. The area under the curve (AUC) of ghrelin (pg/ml min) was lower in PreT: 63,900 (37,260-148,410) than in Cont: 76,560 (56,160-206,385), P=0.027. The AUC of ghrelin increased in PostT, 63,900 (37,260-148,410) vs 107,595 (59,535-357,465), for PreT and PostT respectively, P=0.001. Fasting levels and the AUC of ghrelin were similar in PosT and Cont. Decreased fasting and post-OGTT ghrelin levels in liver failure patients were normalized after liver transplantation.

Plasma Ghrelin Levels in Patients with Familial Mediterranean Fever

Familial mediterranean fever (FMF) is a familial disease characterized by recurrent episodes of febrile serositis, peritonitis, arthritis and pleuritis. Many studies have been performed is an attempt to understand the basis of the inflammatory attacts in FMF. Ghrelin, a recently described orexigene peptide is predominantly produced by stomach. Ghrelin also exerts multiple regulatory effects on immune system. It has reported that grelin has anti-inflammatory effects. There is currently no published evidence demonstrating a role for anti-inflammatory effects of ghrelin in FMF. For this reason, we investigated the role of plasma ghrelin levels in patients with FMF. Thirty seven patients with FMF and 10 healthy controls (5 female, 5 male; mean age 35.4 +/- 5.6 years) were enrolled in this study. Twenty-one patients were in active stage (10 female, 11 male, mean age; 31.0 +/- 5.4 years, mean disease duration 7.2 +/- 3.3 years) and 16 patients were in inactive stage (7 female,9 male, mean age; 33.0 +/- 6.0 years, mean disease duration; 8.7 +/- 3.2 years). Plasma ghrelin levels were determined by EIA. The mean plasma ghrelin levels were 158.4 +/- 52.9 pg/ml in patients with FMF and 56.7 +/- 7.5 pg/ml in healthy controls. The mean plasma ghrelin levels were 190.5 +/- 49.4 pg/ml in the active patients and 116.2 +/- 11.7 pg/ml in the inactive patients. Plasma ghrelin levels were significantly high in patients with FMF compared to healthy controls (p<0.001). Plasma ghrelin levels were significantly high in the active patients compared to in the inactive patients and healthy controls (p<0.001 and p<0.001 respectively). There was significantly difference between in active and inactive patients with FMF (p<0.001). As a results; Plasma ghrelin levels were high both in active and inactive patients with FMF. It is showed that ghrelin may play significant role of the pathogenesis of FMF.

Comparison of Gastric Emptying and Plasma Ghrelin Levels in Patients with Functional Dyspepsia and Non-Erosive Reflux Disease

Background and Aims: The symptoms of postprandial distress syndrome (PDS) and epigastric pain syndrome (EPS), the two subtypes of functional dyspepsia (FD) under the new Rome III classification, tend to overlap with those of non-erosive reflux disease (NERD). Plasma ghrelin levels have been associated with gastric motility; however, clinical studies have yet to examine this relationship among patients with PDS, EPS or NERD. Thus, this study aims to evaluate the correlation between gastric emptying and ghrelin levels as possible candidate factors for gastric motility in these diseases. Methods: One hundred and fifty-one patients presenting with typical symptoms of FD (EPS, n = 36; PDS, n = 76) or NERD (n = 39), and 20 healthy volunteers were enrolled. Gastric motility was evaluated with the T_max value as a marker of gastric emptying using the ¹³C-acetate breath test. We used Rome III criteria to evaluate upper abdominal symptoms, and SRQ-D scores to determine depression status. We measured both acylated and des-acylated ghrelin levels by ELISA methods. Results: The T_max value in PDS patients was significantly higher than in healthy volunteers. Acylated ghrelin levels were significantly lower in NERD and PDS patients than in healthy volunteers. Interestingly, there was significant correlation between the acylated ghrelin levels and T_max value in PDS patients but not in EPS or NERD patients. Conclusion: Our results suggest that acylated ghrelin might play an important role in the pathophysiology of PDS patients through its effect on gastric emptying.

OXYSTEROLS INFLUENCE HEPATIC CELLS HOMEOSTASIS

gastric mucosa due to H. pylori infection may result in decreased numbers of ghrelin producing cells and lower plasma ghrelin levels [7,9]. In contrast, there was not significant difference in plasma ghrelin levels between H. pylori infected patients and H. Pylori uninfected patients in our study; 32,56±21,97 and 34,04±20,59 respectively (p:0,75), similar with another Turkish study [8]. In conclusion, according to our results, there is not a relation between plasma ghrelin levels and H. pylori infection. These conflicting results may be related to different H. pylori strains, as in Turkey the prevalence of the strains, such as CagA, that cause atrophic gastritis is lower [11]. Moreover; differences in studied populations in terms of race, sample size, nutritional status and habits can also affect results. Decreasing plasma ghrelin levels in H. pylori infected subjects can be compensated by other extra gastric ghrelin producing tissues, convenient to our results. All together, further studies are needed to demonstrate the association between H. pylori infection and plasma ghrelin levels.

The acute ghrelin response to a psychological stress challenge does not predict the post-stress urge to eat

Ghrelin is a growth hormone and cortisol secretagogue that plays an important role in appetite and weight regulation. It is not known whether ghrelin is involved in the eating response to stress in humans. In the present study we examined the effects of psychologically induced stress on plasma ghrelin levels in patients with binge-eating disorder (BED) (n=8) and in healthy subjects of normal (n=8) or increased (n=8) body mass index (BMI). Volunteers were subjected to the standardized trier social stress test (TSST). Heart rate, blood pressure, serum cortisol, serum prolactin, and plasma ghrelin levels were measured throughout the test. In addition, subjects were requested to rate their feelings of anxiety, tension, urge to eat uncontrollably and desire to eat sweets by means of a visual analog scale both before and after the TSST. There was a significant rise in the systolic blood pressure (p=0.003) in the study population, reflecting induction of physiological changes by the psychological challenge. Basal ghrelin levels were higher in healthy normal weight (385.4+/-79 pg/ml) than in obese (170.4+/-15.7 pg/ml) subjects (p<0.033). Basal ghrelin levels in patients with BED (240+/-40.8 pg/ml) were at an intermediate level between thin and healthy obese subjects, but this difference did not attain statistical significance. There were no differences in ghrelin levels throughout the test among the groups after correction for BMI, age and gender. A significant difference in the trend time of ghrelin was revealed when the three groups were analyzed according to their cortisol response to stress. Ghrelin levels increased in cortisol responders whereas no change or a decrease in ghrelin levels occurred in cortisol non-responders (p=0.038). Furthermore, a positive correlation was found between the change in ghrelin and the change in cortisol during TSST (r=0.444, p=0.029) but not between the change in ghrelin and the change in systolic blood pressure. The combined score of stress and anxiety was higher in subjects in the higher quartile of ghrelin response in comparison to the lower quartile both before (28.3+/-6.5 vs. 6.6+/-3.3, p=0.0077) and after (61.6+/-9 vs. 28.3+/-11.3, p=0.033) TSST. On the other hand, eating related scores did not differ according to quartiles of ghrelin response. Our findings indicate that a psychological stress may induce an increase in plasma ghrelin levels in humans, and that the post-stress induced urge for uncontrolled eating is not acutely modulated by stress related elevations in ghrelin levels. Furthermore, the stress induced increase in plasma ghrelin was associated with the acute response of serum cortisol to stress, but was independent of BMI or the presence of BED.

Plasma Ghrelin Concentrations in Different Clinical Stages of Diabetic Complications and Glycemic Control in Japanese Diabetics

Ghrelin is an acylated 28-amino-acid peptide that stimulates food intake, GH secretion, and gastric motility. Experimental studies have suggested that ghrelin plays roles in glucose homeostasis, atherosclerosis, and microangiopathy. We investigated possible involvement of ghrelin in micro- and macro-vascular diabetic complications and glycemic control in diabetic patients. Fasting and postprandial plasma ghrelin concentrations after a test meal were measured in 108 and 61 Japanese diabetic patients, respectively. Plasma ghrelin concentrations were negatively correlated with body mass index (BMI) (r = -0.309, P = 0.002) or HbA(1c) (r = -0.264, P = 0.0065). Plasma ghrelin levels in patients with diabetic nephropathy who showed high serum creatinine levels (s-Cre) were significantly higher than those in patients who showed normal s-Cre (P<0.02). In patients with diabetic triopathy, plasma ghrelin concentrations were significantly lower than those in patients without diabetic complications (P<0.05). Stepwise multiple regression analyses revealed that s-Cre, BMI, and HbA(1c) were independently associated with plasma ghrelin levels. A postprandial decrease of ghrelin was observed in patients with normal CV(R-R) values or those with normal body weight, whereas it was not seen in obese patients or in patients with low CV (R-R) values. Suppression rates of ghrelin 30-60 min after a test meal in obese patients were significantly lower than those in normal-weight patients. These findings suggest that ghrelin secretion is suppressed by long-term hyperglycemia and that obesity influences the regulation of ghrelin secretion.

Enhanced plasma ghrelin levels in patients with functional dyspepsia

SummaryBackgroundGhrelin, growth‐hormone‐releasing peptide, has been reported to accelerate food intake and gastrointestinal motility.AimThe present study was designed to investigate the plasma ghrelin levels in patients with functional dyspepsia (FD).Patients and MethodsNinety‐seven patients, who showed no evidence of peptic ulcer disease or gastrointestinal cancer on upper gastrointestinal endoscopy, were recruited. Seventeen patients who had no gastrointestinal symptoms were recruited as controls. Forty‐seven patients were diagnosed to be suffering from FD, based on the Rome II criteria. The FD patients were further subdivided into those with ulcer‐like FD, dysmotility‐like FD and non‐specific‐type FD, based on their Gastrointestinal Symptom Rating Scale (GSRS) scores. Fourteen patients were categorized as having gastro‐oesophageal reflux disease, and 19 patients were excluded as having the irritable bowel syndrome, based on the GSRS. The plasma ghrelin levels were measured by radioimmunoassay.ResultsThe plasma ghrelin levels were significantly higher in FD patients, especially in those with dysmotility‐like FD, as compared with those in controls. The plasma ghrelin levels were also correlated well with the indigestion scores.ConclusionPlasma ghrelin levels are significantly higher in patients with dysmotility‐like FD, suggesting that this parameter could become useful as a novel supportive marker for the diagnosis of FD.

Enhanced plasma ghrelin levels in patients with functional dyspepsia

SummaryBackgroundGhrelin, growth‐hormone‐releasing peptide, has been reported to accelerate food intake and gastrointestinal motility.AimThe present study was designed to investigate the plasma ghrelin levels in patients with functional dyspepsia (FD).Patients and MethodsNinety‐seven patients, who showed no evidence of peptic ulcer disease or gastrointestinal cancer on upper gastrointestinal endoscopy, were recruited. Seventeen patients who had no gastrointestinal symptoms were recruited as controls. Forty‐seven patients were diagnosed to be suffering from FD, based on the Rome II criteria. The FD patients were further subdivided into those with ulcer‐like FD, dysmotility‐like FD and non‐specific‐type FD, based on their Gastrointestinal Symptom Rating Scale (GSRS) scores. Fourteen patients were categorized as having gastro‐oesophageal reflux disease, and 19 patients were excluded as having the irritable bowel syndrome, based on the GSRS. The plasma ghrelin levels were measured by radioimmunoassay.ResultsThe plasma ghrelin levels were significantly higher in FD patients, especially in those with dysmotility‐like FD, as compared with those in controls. The plasma ghrelin levels were also correlated well with the indigestion scores.ConclusionPlasma ghrelin levels are significantly higher in patients with dysmotility‐like FD, suggesting that this parameter could become useful as a novel supportive marker for the diagnosis of FD.

Plasma ghrelin levels in patients with end-stage renal disease.

Ghrelin is an acylated peptide stimulating secretion of the growth hormone (GH). It was originally isolated from the rat stomach as an endogenous ligand for the growth hormone secretagogue receptor. Although being predominantly produced by endocrine cells of the gastric fundus, its secretion has been found in various tissues including the kidney. To study the influence of renal failure on plasma ghrelin levels we examined 16 patients with end-stage renal disease (ESRD) receiving hemodialysis (8 men and 8 women) and 19 controls (10 men and 9 women). Both groups were comparable in age and BMI. In all subjects we assessed plasma levels of ghrelin, leptin, soluble leptin receptor, insulin, IGF-I, IGFBP-1, IGFBP-3 and IGFBP-6. Ghrelin levels were significantly higher in the group of dialyzed patients (4.49+/-0.74 vs. 1.79+/-0.15 ng/ml; p<0.001). These patients had significantly higher levels of GH, IGFBP-1, IGFBP-6, leptin and percentage of body fat (p<0.05). In the group of patients with ESRD plasma ghrelin levels positively correlated with IGFBP-1 (p<0.01). In the control group, ghrelin positively correlated with GH concentrations (p<0.01) and negatively correlated with the levels of insulin and creatinine (p<0.05). In conclusion, patients with ESRD have higher ghrelin concentrations, which might be caused by a decreased excretion/metabolism of ghrelin in the kidney during renal failure.

Low plasma ghrelin levels in patients with Helicobacter pylori–associated gastritis

Low plasma ghrelin levels in patients with Helicobacter pylori–associated gastritis