title: Plasma ghrelin levels are associated with coronary microvascular and endothelial dysfunction in peritoneal dialysis patients.
abstract: Cardiovascular (CV) disease is the main cause of death in peritoneal dialysis (PD) patients, and endothelial dysfunction (ED) is an early sign of vascular pathology. Ghrelin, a gastric peptide with CV actions, has been shown to inhibit proatherogenic changes in experimental models. However, another peptide hormone, leptin, may mediate deleterious effects on the CV system. The aim of this study is to evaluate the relationship between plasma ghrelin and leptin levels, and their association with coronary microvascular and endothelial functions in PD patients. Twenty-four (14 females and 10 males; mean age 44 +/- 12 yr) nondiabetic PD patients, between 18 and 70 years of age, were enrolled. In addition to demographic, clinical, and laboratory parameters, plasma concentrations of ghrelin and leptin were evaluated. Endothelial functions of the coronary arteries were determined by coronary flow reserve (CFR) measurement using transthoracic Doppler echocardiography (TTDE). A CFR value of < 2 was used as an evidence for ED. When the study group was divided according to CFR measurements as CFR < 2 and >or= 2, there were no significant differences considering age, gender, etiology of renal disease, body mass index (BMI), duration of dialysis, PD modality, PD solution type, history of peritonitis, mean arterial pressure, ejection fraction, and biochemical parameters between the two subgroups. Plasma ghrelin levels (129.4 +/- 82.1 pg/mL) in patients with CFR >or= 2 were significantly higher than those in patients with CFR< 2 (63.3 +/- 35.8 pg/mL) (p = 0.03). However, no significant differences in plasma leptin levels were found between these groups [31.39 +/- 37.81 ng/mL vs. 63.95 +/- 72.83 ng/mL (p = 0.28)]. No correlation existed between plasma ghrelin levels and age, BMI, duration of dialysis, mean arterial pressure, ejection fraction, plasma leptin levels, and biochemical parameters. Decreased plasma ghrelin levels may contribute to the development of atherosclerosis in PD patients by causing ED.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey. ykcaliskan@yahoo.com
authors.forename: Yasar
authors.initials: Y
authors.lastname: Caliskan
authors.forename: Numan
authors.initials: N
authors.lastname: Gorgulu
authors.forename: Berna
authors.initials: B
authors.lastname: Yelken
authors.forename: Halil
authors.initials: H
authors.lastname: Yazici
authors.forename: Huseyin
authors.initials: H
authors.lastname: Oflaz
authors.forename: Ali
authors.initials: A
authors.lastname: Elitok
authors.forename: Aydin
authors.initials: A
authors.lastname: Turkmen
authors.forename: Semra
authors.initials: S
authors.lastname: Bozfakioglu
authors.forename: Mehmet Sukru
authors.initials: MS
authors.lastname: Sever
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003324:Coronary Artery Disease / Q000097:blood* / Q000000981:diagnostic imaging; D003326:Coronary Circulation; D003331:Coronary Vessels / Q000000981:diagnostic imaging; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging; D005260:Female; D054439:Ghrelin / Q000097:blood*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000628:therapy; D020738:Leptin / Q000097:blood; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D010530:Peritoneal Dialysis; D014463:Ultrasonography; D055815:Young Adult
chemical_list: D054439:Ghrelin; D020738:Leptin