Ghrelin in chronic liver disease.
OBJECTIVE
Ghrelin is a novel endogenous ligand for the growth hormone (GH) secretagogue receptor involved in energy metabolism, glucose homeostasis and food intake. We investigated the role of ghrelin and insulin-like growth factor-1 (IGF-1), the mediator of the GH axis, in patients with chronic liver diseases (CLD).


METHODS
Ghrelin and IGF-1 serum levels were determined in 105 CLD patients and 97 healthy controls and correlated with clinical and biochemical parameters.


RESULTS
Ghrelin was significantly elevated and IGF-1 reduced in CLD patients compared with healthy controls. IGF-1 serum levels inversely correlated with Child's classification. Ghrelin levels were significantly elevated in Child C cirrhosis patients independent of the aetiology of liver disease. Ghrelin levels did not correlate with liver function. In contrast, there was a correlation of ghrelin with clinical (gastrointestinal bleeding, ascites, encephalopathy) and biochemical (anaemia, inflammatory markers, hypoglycaemia, renal dysfunction) parameters. In a subgroup of patients with CLD and hepatocellular carcinoma (HCC), we observed a strong inverse correlation between alpha-fetoprotein (AFP) and ghrelin levels.


CONCLUSIONS
Unlike IGF-1, ghrelin is not correlated with liver function, but increases in Child C cirrhosis and with complications of CLD. The inverse correlation with AFP in HCC patients requires further studies on the potential impact of ghrelin on the pathogenesis of anorexia-cachexia syndrome.
Tacke
Frank
F
Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany.
Brabant
Georg
G
Kruck
Elmar
E
Horn
Rüdiger
R
Schöffski
Patrick
P
Hecker
Hartmut
H
Manns
Michael P
MP
Trautwein
Christian
C
D000293:Adolescent; D000328:Adult; D000368:Aged; D000855:Anorexia / Q000097:blood; D015415:Biomarkers; D002100:Cachexia / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000097:blood*; D002908:Chronic Disease; D005260:Female; D054439:Ghrelin; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D008103:Liver Cirrhosis / Q000097:blood*; D008113:Liver Neoplasms / Q000097:blood*; D008297:Male; D008875:Middle Aged; D036361:Peptide Hormones / Q000097:blood*; D012044:Regression Analysis; D000509:alpha-Fetoproteins / Q000378:metabolism
D015415:Biomarkers; D054439:Ghrelin; D036361:Peptide Hormones; D000509:alpha-Fetoproteins; D007334:Insulin-Like Growth Factor I