Ghrelin/Leptin-Imbalance in Patients with Primary Biliary Cirrhosis

Abstract

Our data confirm in PBC patients that serum bound leptin levels are increased and clearly show a parallel decrease in serum ghrelin concentrations acting as a physiological counterpart to leptin. Furthermore, we suggest that these changes are linked to the insulin resistance observed in our patients.

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

“…The severity of liver disease was (median and range), according to ChildPugh: 9 (5-12) and the MELD: 14 (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23). Albumin (median and range) was decreased in liver failure patients when compared with the Cont group, 3.0 (2.6-4.6) vs 4.1 (3.4-5.3) g/dl, PZ0.009.…”

“…In the study by Marchesini et al (18), ghrelin levels were not increased in cirrhosis but increased with decreasing Corli score, a method used to quatify and score the amount of ingested food, and along the scale of anorexia/hunger. In patients with primary biliary cirrhosis, Breidert et al (22) found that serum ghrelin levels were decreased in comparison with the Cont group. We have recently found significantly decreased fasting and post-OGTT plasma ghrelin levels in patients with liver failure who were candidates for transplantation when compared with Cont subjects (24).…”

“…Normal, increased, and decreased ghrelin levels have been found in hepatic failure patients (18,(19)(20)(21)(22)(23). We have previously found significantly decreased fasting and post-OGTT plasma ghrelin levels in patients with liver failure who were candidates for transplantation when compared with control subjects (Cont) (24).…”

“…In fact, most of the leading studies on the correlation between metabolic disturbances and ghrelin have focused on the estimation of total ghrelin (10,11,(13)(14)(15), and there are concerns about the specificity of available acylghrelin assays (17). We focused on measuring total ghrelin, with the aim of comparing our data with the discrepant total ghrelin levels that have been found in hepatic failure patients in different studies (18)(19)(20)(21)(22)(23)(24).…”

Ghrelin Gene Products and the Regulation of Food Intake and Gut Motility

“…On the other hand, patients with liver cirrhosis had a lower energy intake, higher resting energy expenditure (Kalaitzakis et al, 2007), higher fasting sugar (Kalaitzakis et al, 2007(Kalaitzakis et al, , 2009) and leptin levels (Breidert et al, 2004;Ataseven et al, 2006;Kalaitzakis et al, 2007Kalaitzakis et al, , 2009, and higher insulin resistance (Kalaitzakis et al, 2007(Kalaitzakis et al, , 2009. Plasma fasting total ghrelin levels were found to be either unchanged (Marchesini et al, 2004;Kalaitzakis et al, 2007Kalaitzakis et al, , 2009, elevated (Tacke et al, 2003;Ataseven et al, 2006), or decreased (Breidert et al, 2004;Diz-Lois et al, 2009) in patients with cirrhosis compared with control subjects.…”