Low Serum Acylated Ghrelin Levels are Associated with the Development of Cardiovascular Disease in Hemodialysis Patients

Chou, Chia Chi; Bai, Chyi‐Huey; Tsai, Shau‐Wei; Wu, Mai-Szu

doi:10.2169/internalmedicine.49.3047

Cited by 15 publications

(17 citation statements)

References 47 publications

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“…Further, the levels of acyl ghrelin were lowest in the severe SGA category of malnutrition and in patients with poor appetite. It has been reported that low acyl ghrelin is associated with poor nutritional status, loss of appetite (Oner-Iyidogan et al 2011) and CVD (Chou et al 2010).…”

Section: Discussionmentioning

confidence: 99%

Association of genetic variants of ghrelin, leptin and UCP2 with malnutrition inflammation syndrome and survival in end-stage renal disease patients

et al. 2013

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Section: Discussionmentioning

confidence: 99%

Association of genetic variants of ghrelin, leptin and UCP2 with malnutrition inflammation syndrome and survival in end-stage renal disease patients

et al. 2013

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“…In general, plasma ghrelin level increases after fasting and decreases after eating and plasma ghrelin level was found to associate with nutritional disorder in patients with advanced-stage cancer and anorexia nervosa[14]. A low ghrelin level increases the risk of cardiovascular mortality and morbidity in hemodialysis patients[15], and in recent clinical trials, administration of ghrelin improved appetite and food intake in dialysis patients[16,17]. The usefulness of monitoring plasma ghrelin at fixed intervals as a biomarker for mortality in hemodialysis patients has been proven[7].…”

Section: Introductionmentioning

confidence: 99%

Relationship between ghrelin,Helicobacter pyloriand gastric mucosal atrophy in hemodialysis patients

Ichikawa¹,

Sugimoto²,

Sakao³

et al. 2016

WJG

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AIMTo investigate the relationship between plasma ghrelin level, Helicobacter pylori (H. pylori) infection status and the severity of atrophy in hemodialysis patients.METHODSOne hundred eights patients who received hemodialysis and 13 non-hemodialysis H. pylori-negative controls underwent gastroduodenoscopy to evaluate the severity of gastric atrophy. Serum levels of pepsinogen (PG) were measured as serum markers of gastric atrophy. H. pylori infection was evaluated by anti-H. pylori IgG antibody, rapid urease test and culture test. We classified H. pylori infection status as non-infection, present infection and past infection. In addition, plasma acyl-ghrelin and desacyl-ghrelin levels were measured by enzyme-linked immunosorbent assay.RESULTSInfection rate of H. pylori was 45.4% (49/108). Acyl-ghrelin level in the non-infection group (39.4 ± 23.0 fmol/mL) was significantly higher than in the past (23.4 ± 19.9 fmol/mL, P = 0.005) and present infection groups (19.5 ± 14.0 fmol/mL, P < 0.001). Furthermore, desacyl-ghrelin level in the non-infection group (353.2 ± 190.2 fmol/mL) was significantly higher than those in the past (234.9 ± 137.5 fmol/mL, P = 0.008) and present infection groups (211.8 ± 124.2 fmol/mL, P < 0.001). Acyl-ghrelin was positively correlated with the PG I level and PG I/II ratio (|R| = 0.484, P < 0.001 and |R| = 0.403, P < 0.001, respectively). Both ghrelins were significantly decreased in accordance with the progress of endoscopic atrophy (both P < 0.001) and acyl-ghrelin was significantly lower in patients with mild, moderate and severe atrophy (24.5 ± 23.1 fmol/mL, 20.2 ± 14.9 fmol/mL and 18.3 ± 11.8 fmol/mL) than in those with non-atrophy (39.4 ± 22.2 fmol/mL, P = 0.039, P = 0.002 and P < 0.001, respectively).CONCLUSIONIn hemodialysis patients, plasma ghrelin level was associated with the endoscopic and serological severity of atrophy related to H. pylori infection.

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“…We did not find significant associations of current H. pylori infection with the plasma ghrelin level. However, our observations might suggest that management practices, such as H. pylori eradication therapy, before the development/progression of atrophy is necessary to prevent the decrease of ghrelin level that is related with cardiovascular mortality and morbidity and with PEW in HD patients [6,7] . In addition, we demonstrated that because there was a positive correlation between PG I and ghrelin levels even in HD patients, ghrelin, PG I, and PG II levels, and PG I/II ratio might be useful markers for atrophy related with gastric cancer development and for nutrition status.…”

Section: Discussionmentioning

confidence: 90%

“…Administration of ghrelin is reported to improve problems in cachectic patients with congestive heart failure and chronic obstructive pulmonary disease [2] . However, although a low ghrelin level is a risk factor for cardiovascular mortality and morbidity in HD patients [6,7] , it is still unclear whether PEW status in HD patients significantly correlates with the plasma ghrelin level. In recent clinical trials, administration of ghrelin improved appetite and food intake in dialysis patients [8,9] .…”

mentioning

confidence: 99%

Severity of Gastric Mucosal Atrophy Is the Major Determinant of Plasma Ghrelin Level in Hemodialysis Patients

Sakao

Sugimoto²,

Ichikawa³

et al. 2016

Am J Nephrol

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Background: Ghrelin, an orexigenic hormone, has multiple favorable functions including protein anabolism enhancement, anti-inflammatory actions, and cardiovascular protection. A low plasma ghrelin level is associated with increased mortality in patients treated with hemodialysis (HD). However, it is unclear whether the plasma ghrelin level in HD patients correlates with the severity of gastric mucosal atrophy and Helicobacter pylori status. Methods: Seventy-eight maintenance HD patients and 51 non-dialysis patients with chronic kidney disease were evaluated for severity of gastric mucosal atrophy by gastroduodenoscopy and for H. pylori status using an anti-H. pylori-antibody and rapid urease test. Plasma acyl and des-acyl ghrelin levels were measured and their associations with relevant clinical parameters were investigated. Results: Des-acyl ghrelin level in HD patients was significantly higher than that in patients with kidney function preserved. Although acyl and des-acyl ghrelin levels were similar between current H. pylori positive and negative HD patients, both levels decreased significantly with the progress of endoscopic gastric mucosal atrophy in HD patients. Serum pepsinogen (PG) I level and PG I/II ratio decreased significantly according to the severity of atrophy in HD patients and positively significantly correlated with both ghrelin levels. Multiple regression analysis showed significant positive correlations between acyl ghrelin and PG I levels (β = 0.738, p < 0.001) and significant negative correlations between ghrelin and age, albumin, and creatinine levels. Conclusions: Gastric atrophy is the major determinant of ghrelin level in HD patients. Management practices, such as H. pylori eradication, before advanced atrophy may be required to prevent the decrease of ghrelin levels and improve the prognosis of HD patients.

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Low Serum Acylated Ghrelin Levels are Associated with the Development of Cardiovascular Disease in Hemodialysis Patients

Cited by 15 publications

References 47 publications

Association of genetic variants of ghrelin, leptin and UCP2 with malnutrition inflammation syndrome and survival in end-stage renal disease patients

Association of genetic variants of ghrelin, leptin and UCP2 with malnutrition inflammation syndrome and survival in end-stage renal disease patients

Relationship between ghrelin,Helicobacter pyloriand gastric mucosal atrophy in hemodialysis patients

Severity of Gastric Mucosal Atrophy Is the Major Determinant of Plasma Ghrelin Level in Hemodialysis Patients

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