Assessment of Serum Acylated Ghrelin in Children and Adolescents with Chronic Liver Diseases: Relation to Nutritional Status

Abstract

Because ghrelin is one of the key hormones in regulating feeding behavior and caloric status, it was suggested that ghrelin behavior might be closely associated with malnutrition state of patients with chronic liver disease (CLD). Thus, we aimed to assess serum ghrelin levels in children with CLD and its relation to anthropometric parameters and severity of CLD. Forty CLD patients were studied in comparison to 40 controls. All subjects were subjected to history, anthropometric, and laboratory assessment of liver functions and serum acylated ghrelin. Ghrelin was higher in patients than controls being higher with progress of Child's grade and with deterioration of liver functions. Hyperghrelinemia was detected in 62.5% of cases. Ghrelin correlated negatively with body mass index standard deviation score (BMISDS ( = −0.95, < 0.001)), triceps skin fold thickness (TSFT ( = −0.88, < 0.001)), and subscapular skin fold thickness (SSFT ( = 0.83, < 0.001)) percentiles. In conclusion, hyperghrelinemia may represent a compensatory mechanism trying to overcome malnutrition state complicating CLD and can be used as a parameter for early detection and assessment of the severity of malnutrition in children with CLD.

Concentrations of Ghrelin and Leptin in Children with Cystic Fibrosis

“…Elkabbany observed abnormalities in the concentrations of acylated ghrelin in the blood serum of children and adolescents with chronic liver diseases, however they mainly correlated with the nutritional status. Our observations also confirm this data [26,31,32]. Koch observed elevated levels of ghrelin in the blood serum of critically ill patients with acute sepsis -it was a factor for the necessity of hospitalisation in the A&E department [33] Ghrelin acts preventatively against the formation of stones in the area of the gallbladder and bile ducts, which are significantly more common in cystic fibrosis and concern 14-24% of patients.…”

“…Low levels of Linoleic Acid (LA), Docosahexaenoic Acid (DHA) and Docosapentaenoic (DPA) acid, as well as insufficient level of antioxidants are observed in those children. The concentration of ghrelin rises significantly in patients with chronic liver diseases [26][27][28][29]. Among our patients with diagnosed cystic fibrosis, elevated parameters of damage to liver cell were observed in just less than half of the patients.…”

Liver diseases among Arab world, current state and unmet needs, a scoping review

“…Liver cirrhosis can cause multisystem affection, cardiopulmonary complications can occur secondary to liver cirrhosis, many publications among Arabs had studied the cardiopulmonary complications, as regard cardiac muscle affection and myocardial perfusion abnormalities (325)(326)(327)(328), hepatic hydrothorax (329,330), affection of respiratory function (331)(332)(333) and hepatopulmonary syndrome (334) While investigating the publications studying liver cirrhosis and its complications among Arabs, sporadic studies about metabolic bone mineral affection (335)(336)(337), fasting in Ramadan and liver cirrhosis (338,339), nutrition and malnutrition among cirrhotic patients (340,341), sleep pattern and disturbance (342,343), refractory ascites (344,345), stem cell transplantation and liver cirrhosis (346)(347)(348) and liver cirrhosis and fertility (349). Many studies about hepatocellular detection in cirrhotic patients which will be discussed later.…”