title: Total and acylated ghrelin in liver cirrhosis: correlation with clinical and nutritional status.
abstract: OBJECTIVE
  The pathogenesis of anorexia in cirrhotic patients is complex and the appetite-modulating hormone ghrelin could be involved. Acylated ghrelin is the biologically active form that modifies insulin sensitivity and body composition. The aim of the present study was to compare acylated and total ghrelin concentration in patients with liver cirrhosis and to investigate the possible relationship between ghrelin and clinical and nutritional parameters.
  
  
  METHODS
  Sixty patients with viral liver cirrhosis who did not have hepatocellular carcinoma or acute infections were studied. Twenty healthy volunteers were recruited after matching for age, gender, and body mass index with the patients and served as controls. Fasting levels of total, acylated ghrelin, leptin, TNF-alpha and insulin were measured in all subjects, in addition, clinical and nutrition parameters were assessed.
  
  
  RESULTS
  In cirrhotic patients, plasma levels of both acylated and total ghrelin were significantly higher than those in the controls. The mean plasma acylated ghrelin levels were significantly higher in Child C cirrhosis compared to Child A and B. Ghrelin (total and acylated) were negatively correlated with leptin in cirrhotic patients confirming the fact that leptin acts as a physiological counterpart of ghrelin.
  
  
  CONCLUSIONS
  Nutritional and metabolic abnormalities in cirrhotic patients may be dependent on the changes in the ghrelin/leptin systems, mainly the acylated form of ghrelin.
authors.affiliation: Department of Medical Biochemistry, Cairo University, Cairo 11562, Egypt. amrsh2006@yahoo.com
authors.forename: Amal M
authors.initials: AM
authors.lastname: El-Shehaby
authors.forename: Eman M
authors.initials: EM
authors.lastname: Obaia
authors.forename: Sahar S
authors.initials: SS
authors.lastname: Alwakil
authors.forename: Ahmed A
authors.initials: AA
authors.lastname: Hiekal
mesh_terms: D000215:Acylation; D005260:Female; D054439:Ghrelin / Q000097:blood*; D006801:Humans; D020738:Leptin / Q000097:blood; D008103:Liver Cirrhosis / Q000097:blood* / Q000175:diagnosis / Q000821:virology; D008297:Male; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: D054439:Ghrelin; D020738:Leptin; D014409:Tumor Necrosis Factor-alpha