title: [The changes of ghrelin, growth hormone, growth hormone releasing hormone and their clinical significances in patients with chronic obstructive pulmonary disease].
abstract: OBJECTIVE
  To investigate the changes of plasma ghrelin, growth hormone (GH) and growth hormone releasing hormone (GHRH) and gastric ghrelin in patients with chronic obstructive pulmonary disease (COPD) and to explore their clinical significances.
  
  
  METHODS
  Plasma ghrelin, GH, GHRH, TNFα, IL-6 and C reactive protein (CRP) were measured in 40 COPD patients and 20 controls with chronic bronchitis. Correlated factors of plasma ghrelin, TNFα, IL-6, CRP were analyzed. Body composition was assessed with bioelectrical impedance analysis. The expression of gastric ghrelin in patients with COPD was detected.
  
  
  RESULTS
  Plasma ghrelin was higher in the underweight patients than in the normal weight patients and in the controls [(1.78 ± 0.46) ng/L, (1.39 ± 0.46) ng/L, (1.36 ± 0.39) ng/L, respectively]. Plasma GH was lower in the underweight patients than in the normal weight patients and in the controls [(4.12 ± 0.83) µg/L, (5.17 ± 0.72)µg/L, (6.49 ± 1.13) µg/L, respectively]. Plasma GHRH was lower in the underweight patients than in the normal weight patients and in the controls [(20.43 ± 4.41) ng/L, (23.47 ± 3.97) ng/L, (27.48 ± 10.06) ng/L, respectively]. Plasma ghrelin was higher in the underweight patients than in the controls (P < 0.01). Plasma ghrelin was higher in the underweight patients than in the normal weight patients with COPD. Plasma ghrelin (log transformed) was negatively correlated with BMI and percentage of body fat in the COPD patients. Plasma GHRH was positively correlated with ghrelin in the underweight patients (r = 0.515, P < 0.05), while no correlation was found between plasma GH and ghrelin in the underweight patients (r = 0.415, P > 0.05). Plasma ghrelin was positively correlated with TNFα and IL-6 in the underweight patients. The gastric expression of ghrelin showed no evident difference between the patients with COPD and the controls.
  
  
  CONCLUSIONS
  The plasma GH in COPD patients may not be correlated with ghrelin. The plasma ghrelin level may be a useful indicator for malnutrition in COPD patients. Plasma ghrelin might be involved in the pathogenesis of CODP by affecting the body energy metabolism.
authors.affiliation: Department of Respiratory Medicine, Affiliated Hospital of Shaoxing University, Shaoxing, Zhejiang Province, China. xuzhisong2004@sina.com
authors.forename: Zhi-song
authors.initials: ZS
authors.lastname: Xu
authors.forename: Zi-yu
authors.initials: ZY
authors.lastname: Bao
authors.forename: Zhi-ying
authors.initials: ZY
authors.lastname: Wang
authors.forename: Guo-jun
authors.initials: GJ
authors.lastname: Yang
authors.forename: Dong-fang
authors.initials: DF
authors.lastname: Zhu
authors.forename: Li
authors.initials: L
authors.lastname: Zhang
authors.forename: Rong-mei
authors.initials: RM
authors.lastname: Tan
mesh_terms: D000368:Aged; D001823:Body Composition; D016022:Case-Control Studies; D054439:Ghrelin / Q000097:blood / Q000378:metabolism*; D013006:Growth Hormone / Q000097:blood / Q000378:metabolism*; D013007:Growth Hormone-Releasing Hormone / Q000097:blood / Q000378:metabolism*; D006801:Humans; D008297:Male; D029424:Pulmonary Disease, Chronic Obstructive / Q000097:blood / Q000378:metabolism*; D013851:Thinness / Q000503:physiopathology
chemical_list: D054439:Ghrelin; D013006:Growth Hormone; D013007:Growth Hormone-Releasing Hormone