Relation of ghrelin, leptin and inflammatory markers to nutritional status in active pulmonary tuberculosis.
OBJECTIVE
Malnutrition is a prominent feature of tuberculosis. Little is known about the role of the appetite-related hormones, ghrelin and leptin, in malnutrition in tuberculosis. This study was undertaken to determine whether ghrelin and leptin contribute to malnutrition in active pulmonary tuberculosis.


METHODS
Nutritional parameters and plasma levels of ghrelin, leptin, and inflammatory cytokines were measured before treatment and after clinical improvement following anti-tuberculosis chemotherapy in 23 tuberculosis subjects and 23 healthy controls prospectively. Patients were divided into well-nourished (n=15) and malnourished (n=8) groups.


RESULTS
Ghrelin but not leptin levels were significantly lower in the malnourished tuberculosis group than in the well-nourished tuberculosis group [44.0 (43.0-54.0) vs. 122 (108-158)pg/mL; p<0.05]. Malnutrition score was negatively correlated to ghrelin (rho=-0.76, p<0.01) but not to leptin levels. TNF-alpha and IL-6 levels were significantly higher in the malnourished tuberculosis group than in the well-nourished tuberculosis group and controls. Plasma levels of ghrelin tended to decrease as inflammatory cytokines increased before treatment.


CONCLUSIONS
Decreased plasma ghrelin levels, in addition to increased plasma inflammatory cytokine levels, may be associated with malnutrition in active pulmonary tuberculosis.
College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, South Korea.
Ji Hae
JH
Kim
Choon-Taek
CT
Lee
Ho Il
HI
Yoon
Junghan
J
Song
Wan Gyoon
WG
Shin
Jae Ho
JH
Lee
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000995:Antitubercular Agents / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D005260:Female; D054439:Ghrelin / Q000097:blood*; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D015850:Interleukin-6 / Q000097:blood; D020738:Leptin / Q000097:blood*; D008297:Male; D044342:Malnutrition / Q000097:blood / Q000453:epidemiology* / Q000209:etiology; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D015596:Nutrition Assessment; D009752:Nutritional Status; D012720:Severity of Illness Index; D013183:Sputum / Q000382:microbiology; D014397:Tuberculosis, Pulmonary / Q000097:blood* / Q000188:drug therapy / Q000503:physiopathology*; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D055815:Young Adult
D000995:Antitubercular Agents; D015415:Biomarkers; D054439:Ghrelin; C508600:IL6 protein, human; D018836:Inflammation Mediators; D015850:Interleukin-6; D020738:Leptin; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein