Comparison of gastric emptying and plasma ghrelin levels in patients with functional dyspepsia and non-erosive reflux disease.
OBJECTIVE
The symptoms of postprandial distress syndrome (PDS) and epigastric pain syndrome (EPS), the two subtypes of functional dyspepsia (FD) under the new Rome III classification, tend to overlap with those of non-erosive reflux disease (NERD). Plasma ghrelin levels have been associated with gastric motility; however, clinical studies have yet to examine this relationship among patients with PDS, EPS or NERD. Thus, this study aims to evaluate the correlation between gastric emptying and ghrelin levels as possible candidate factors for gastric motility in these diseases.


METHODS
One hundred and fifty-one patients presenting with typical symptoms of FD (EPS, n = 36; PDS, n = 76) or NERD (n = 39), and 20 healthy volunteers were enrolled. Gastric motility was evaluated with the T(max) value as a marker of gastric emptying using the 13C-acetate breath test. We used Rome III criteria to evaluate upper abdominal symptoms, and SRQ-D scores to determine depression status. We measured both acylated and des-acylated ghrelin levels by ELISA methods.


RESULTS
The Tmax value in PDS patients was significantly higher than in healthy volunteers. Acylated ghrelin levels were significantly lower in NERD and PDS patients than in healthy volunteers. Interestingly, there was significant correlation between the acylated ghrelin levels and Tmax value in PDS patients but not in EPS or NERD patients.


CONCLUSIONS
Our results suggest that acylated ghrelin might play an important role in the pathophysiology of PDS patients through its effect on gastric emptying.
Shindo
Tomotaka
T
Department of Internal Medicine, Division of Gastroenterology, Nippon Medical School, Tokyo 113-8602, Japan.
Futagami
Seiji
S
Hiratsuka
Tetsuro
T
Horie
Akane
A
Hamamoto
Tatsuhiko
T
Ueki
Nobue
N
Kusunoki
Masafumi
M
Miyake
Kazumasa
K
Gudis
Katya
K
Tsukui
Taku
T
Iwakiri
Katsuhiko
K
Sakamoto
Choitsu
C
D000215:Acylation; D000328:Adult; D001944:Breath Tests; D002247:Carbon Isotopes / Q000032:analysis; D016022:Case-Control Studies; D004415:Dyspepsia / Q000097:blood / Q000473:pathology / Q000503:physiopathology*; D005260:Female; D005746:Gastric Emptying; D005753:Gastric Mucosa / Q000473:pathology; D005764:Gastroesophageal Reflux / Q000097:blood / Q000473:pathology / Q000503:physiopathology*; D054439:Ghrelin / Q000097:blood*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged
D002247:Carbon Isotopes; D054439:Ghrelin