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

Diz-Lois, M T; García-Buela, Jesús; Suárez, Francisco; Sangiao‐Alvarellos, Susana; Vidal, Ovidio; Cordido, Fernando

doi:10.1530/eje-10-0508

Cited by 17 publications

(8 citation statements)

References 47 publications

(94 reference statements)

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“…Other contributors that could facilitate the expansion of the somatotroph tumor cells are hypothalamic GHRH or somatostatin, paracrine growth factors, and ghrelin [1, 3]. Recent data suggest the importance of the role of ghrelin in the pathophysiological regulation of GH [4–6]. Over 90% of patients with acromegaly have a benign monoclonal pituitary adenoma, which are not surrounded by hyperplasic tissue.…”

Section: Introductionmentioning

confidence: 99%

Clinical Manifestations and Diagnosis of Acromegaly

Lugo

Pena

Cordido

2012

International Journal of Endocrinology

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104

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Acromegaly and gigantism are due to excess GH production, usually as a result of a pituitary adenoma. The incidence of acromegaly is 5 cases per million per year and the prevalence is 60 cases per million. Clinical manifestations in each patient depend on the levels of GH and IGF-I, age, tumor size, and the delay in diagnosis. Manifestations of acromegaly are varied and include acral and soft tissue overgrowth, joint pain, diabetes mellitus, hypertension, and heart and respiratory failure. Acromegaly is a disabling disease that is associated with increased morbidity and reduced life expectancy. The diagnosis is based primarily on clinical features and confirmed by measuring GH levels after oral glucose loading and the estimation of IGF-I. It has been suggested that the rate of mortality in patients with acromegaly is correlated with the degree of control of GH. Adequately treated, the relative mortality risk can be markedly reduced towards normal.

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Section: Introductionmentioning

confidence: 99%

Clinical Manifestations and Diagnosis of Acromegaly

Lugo

Pena

Cordido

2012

International Journal of Endocrinology

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104

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“…Other contributors that could facilitate the expansion of the somatotroph tumor cells are hypothalamic GHRH or somatostatin, paracrine growth factors and ghrelin [2], [4]. Recent data suggest the importance of the role of ghrelin in the pathophysiological regulation of GH [5]–[7]. Current treatment for acromegaly includes neurosurgery, radiotherapy and medical therapy with dopamine agonists, somatostatin analog (SSA), and the GH-receptor antagonist pegvisomant [2], [8]–[10].…”

Section: Introductionmentioning

confidence: 99%

Place of Preoperative Treatment of Acromegaly with Somatostatin Analog on Surgical Outcome: A Systematic Review and Meta-Analysis

et al. 2013

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ContextTranssphenoidal neurosurgery is the accepted first-line treatment of acromegaly in the majority of patients. Previous studies addressing preoperative somatostatin analog (SSA) treatment and subsequent surgical cure rates are conflicting, reporting either benefits or no significant differences.ObjectiveThe aim of this study, based on a meta-analysis of all published reports, was to investigate whether treatment with SSA before surgery improves the surgical outcome of acromegaly.Data SourcesAll studies of preoperative treatment of acromegaly with SSA were systematically reviewed up to December 2011. We searched the Medline, Embase, Cochrane and Google Scholar electronic databases. Study Selection: The primary endpoint was the biochemical postoperative cure rate. We identified 286 studies, out of which 10 studies (3.49%) fulfilling the eligibility criteria were selected for analysis; five retrospective studies with a control group, two prospective non-randomized trials, and three prospective controlled trials. The meta-analysis was conducted using the random-effects model.Data ExtractionData were extracted from published reports by two independent observers. Data Synthesis: A borderline effect was detected in the analysis of all of the trials with control groups, with a pooled odds ratio (OR) for biochemical cure with SSA treatment of 1.62 (95% CI, 0.93–2.82). In the analysis of the three prospective controlled trials, a statistically significant effect was idenfified OR: 3.62 (95% CI, 1.88–6.96).ConclusionsPreoperative treatment with SSA og GH-secreting pituitary adenomas shows a significant improvement on surgical results. This meta-analysis suggests that in centers without optimal results all patients with a GH-secreting pituitary macroadenoma should be treated with a long-acting SSA prior to surgical treatment.

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“…Several experimental studies showed protective effect of ghrelin on the liver [20, 21] and decreased circulating ghrelin level in patients with NAFLD has been reported [22]. Furthermore, decreased plasma levels of ghrelin in patients with liver failure were normalized after liver transplantation [23]. Several experimental studies have demonstrated the presence of ghrelin in gastric mucosa.…”

Section: Introductionmentioning

confidence: 99%

Plasma insulin, leptin, adiponectin, resistin, ghrelin, and melatonin in nonalcoholic steatohepatitis patients treated with melatonin

Gonciarz¹,

Bielański

Partyka³

et al. 2012

Journal of Pineal Research

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Insulin resistance, oxidative stress, and an abnormal production of adipokines and cytokines are implicated in the pathogenesis of nonalcoholic steatohepatitis (NASH). Recently, we reported a significant improvement in plasma liver enzymes among patients with NASH treated with melatonin. In this study, we investigated the effect of melatonin, administered at a dose of 10 mg/day for 28 days to 16 patients with histologically proven NASH on insulin resistance (HOMA-IR), on the plasma levels of adiponectin, leptin, ghrelin, and resistin. Additionally, plasma levels of aminotransferases and gamma glutamyltranspeptidase as well as plasma concentrations of melatonin were evaluated. Median baseline values of HOMA-IR, leptin (ng/mL), and resistin (pg/mL) in patients with NASH were significantly higher in comparison with controls: 4.90 versus 1.60, 10.70 versus 4.30, and 152 versus 91, respectively. Median adiponectin level (μg/mL) was decreased in patients compared to controls: 6.40 versus 16.25; no significant difference in ghrelin levels between patients and controls was found. After melatonin treatment, the median value of HOMA-IR was significantly reduced by 60% as compared to baseline values, whereas adiponectin, leptin, and ghrelin plasma levels rose significantly by 119%, 33%, and 20%, respectively; the difference between pre-/posttreatment in plasma resistin levels was not significant. These findings make melatonin a suitable candidate for testing in patients with NASH in the large controlled clinical trials.

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

Cited by 17 publications

References 47 publications

Clinical Manifestations and Diagnosis of Acromegaly

Clinical Manifestations and Diagnosis of Acromegaly

Place of Preoperative Treatment of Acromegaly with Somatostatin Analog on Surgical Outcome: A Systematic Review and Meta-Analysis

Plasma insulin, leptin, adiponectin, resistin, ghrelin, and melatonin in nonalcoholic steatohepatitis patients treated with melatonin

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