Serum Ghrelin Levels in Inflammatory Bowel Disease with Relation to Disease Activity and Nutritional Status

Abstract

Ghrelin possesses various biological activities -- it stimulates growth hormone (GH) release, plays a major role in energy metabolism, and is one of the hormones that affects body composition. It also plays a role in modulating immune response and inflammatory processes. In this study we aimed to determine whether serum ghrelin levels had correlation with markers associated with disease activation. We also investigated any probable relationship between serum ghrelin level and nutritional status. Serum levels of ghrelin and its relationship with disease activity and nutritional status were evaluated in 34 patients with ulcerative colitis (UC), 25 patients with Crohn's disease (CD), and 30 healthy controls. Serum ghrelin levels, serum IGF-1 and GH levels, and markers of disease activity (sedimentation, C-reactive protein, and fibrinogen) were measured in all subjects. Body composition and nutritional status was assessed by both direct (by anthropometry) and indirect (by bioimpedance) methods. Serum ghrelin levels were significantly higher in patients with active UC and CD than in those in remission (108 +/- 11 pg/ml vs. 71 +/- 13 pg/ml for UC patients, P < 0.001; 110 +/- 10 pg/ml vs. 75 +/- 15 pg/ml for CD patients, P < 0.001). Circulating ghrelin levels in UC and CD patients were positively correlated with sedimentation, fibrinogen and CRP and was negatively correlated with IGF-1, BMI, TSFT, MAC, fat mass (%), and fat free mass (%). This study demonstrates that patients with active IBD have higher serum ghrelin levels than patients in remission and high levels of circulating ghrelin correlate with the severity of disease and the activity markers. Ghrelin levels in inflammatory bowel disease (IBD) patients show an appositive correlation with IGF-1 and bioelectrical impedance analysis, body composition, and anthropometric assessments. Finally, we arrived at the conclusion that ghrelin level may be important in determination of the activity in IBD patients and evaluation of nutritional status.

Gastroduodenal Symptoms in Inflammatory Bowel Disease Are Correlated with Gastric Emptying and Serum Levels of Active Ghrelin

“…This association probably could not be related with activity of the disease. Once it was demonstrated by Ates et al [22] that there was a higher serum ghrelin level in active IBD than in remission disease, and these high levels of circulating ghrelin correlate with the severity and activity of IBD. Similar to our results, Kim et al [23] demonstrated that FD patients with higher plasma levels of fasting ghrelin suffered from less epigastric pain.…”

Ghrelin receptor modulates T helper cells during intestinal inflammation

“…13,[32][33][34] Noteworthy, high serum ghrelin levels have been reported in patients suffering from chronic intestinal inflammatory disorders such as ulcerative colitis and Crohn's disease. In these patients increased ghrelin levels correlates with an increase in systemic TNF-a and C-reactive protein.…”

Ghrelin in gastrointestinal diseases and disorders: A possible role in the pathophysiology and clinical implications (Review)

“…Circulating gherlin levels in UC and CD patients were positively correlated with sedimentation, C-reactive protein and fibrinogen and negatively correlated with nutritional status parameters (23). It was concluded that gherlin is important in determination of activity in inflammatory bowel diseases (IBD) patients and evaluation of nutritional status.…”

“…Serum gherlin levels are significantly higher in patients with active ulcerative colitis (UC) and Crohn's disease (CD) than those in remission or controls (21)(22)(23). Circulating gherlin levels in UC and CD patients were positively correlated with sedimentation, C-reactive protein and fibrinogen and negatively correlated with nutritional status parameters (23).…”