Circulating ghrelin levels in celiac patients.
OBJECTIVE
Ghrelin, the gut-brain peptide, recently identified as the natural endogenous ligand for growth hormone secretagogue receptors, exerts various endocrine and nonendocrine effects, including the control of energy homeostasis and food intake, but its possible relevance in malabsorption syndromes is unknown. Therefore, the aim of this study was to evaluate circulating ghrelin levels in adults with untreated and treated celiac disease (CD) and, for comparison, in healthy subjects.


METHODS
Fasting serum ghrelin levels were measured in 30 consecutive patients with newly diagnosed CD, 13 celiac patients successfully treated with a gluten-free diet (GFD), and 30 healthy controls.


RESULTS
Ghrelin levels were abnormally high in patients with active CD compared with controls (297 +/- 17.6 vs 218 +/- 15.2 pmol/L, p<0.01) and correlated positively with intestinal mucosal lesion severity (rs=0.444, p<0.02). In the successfully GFD-treated patients, ghrelin values were normal compared with controls (233 +/- 22.0 vs 218 +/- 15.2 pmol/L, ns) and, moreover, correlated negatively with body mass index (r=-0.632, p=0.02), unlike in the untreated patient group (r=-0.263, ns).


CONCLUSIONS
High ghrelin levels characterized our series of adult patients with newly diagnosed CD and correlated significantly with the degree of severity of intestinal mucosal lesions. This is the first evidence of a relationship between ghrelin and inflammatory processes, but the mechanisms involved are still unclear. Furthermore, our findings suggest that an interplay of hormonal, metabolic, and nutritional factors could influence ghrelin secretion under pathophysiological circumstances.
Peracchi
Maddalena
M
Gastroenterology, IRCCS-Ospedale Maggiore, University of Milan, Milan, Italy.
Conte
Dario
D
Terrani
Claudia
C
Pizzinelli
Simona
S
Gebbia
Carlotta
C
Cappiello
Vincenzo
V
Spada
Anna
A
Bardella
Maria Teresa
MT
D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D002446:Celiac Disease / Q000175:diagnosis* / Q000178:diet therapy; D004035:Diet Therapy / Q000379:methods; D005260:Female; D054439:Ghrelin; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D036361:Peptide Hormones / Q000097:blood* / Q000378:metabolism; D011336:Probability; D011379:Prognosis; D012016:Reference Values; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index
D015415:Biomarkers; D054439:Ghrelin; D036361:Peptide Hormones