Acyl-ghrelin and obestatin plasma levels in different stages of chronic kidney disease.
OBJECTIVE
This study assessed acyl-ghrelin and obestatin plasma levels in nondialysis chronic kidney disease (CKD) and hemodialysis (HD) patients compared with healthy volunteers.


METHODS
This was a cross-sectional study conducted at Renal Vida Clinic (Rio de Janeiro, Brazil) and Renal Nutrition Ambulatory (Niterói, Brazil).


METHODS
Sixty-four subjects were studied: 29 HD patients (55.4 ± 10.5 years, body mass index [BMI], 24.4 ± 3.9 kg/m(2), 17 men); 19 nondialysis patients (59.8 ± 7.5 years, BMI, 26.3 ± 4.8 kg/m(2), glomerular filtration rate, 28.8 ± 10.5 mL/minute/1.73 m(2), 5 men), and 16 healthy volunteers (53.8 ± 5.4 years, BMI, 24.6 ± 2.7 kg/m(2), 7 men).


METHODS
Acyl-ghrelin and obestatin were assessed using enzyme immunometric assays. Body weight, height, waist circumference (WC), and skinfold were measurement, and body fat percentage, arm muscle area, BMI, and conicity index were calculated. The average daily intake of calories and protein were estimated using a 3-day, 24-hour dietary recall, and the appetite was assessed by the first question of the Hemodialysis Study Appetite Questionnaire.


RESULTS
The highest serum acyl-ghrelin (34.1 ± 13.0 pg/mL) and acyl-ghrelin/obestatin ratio (34.0 [6.7-90.2]) were found in nondialysis CKD patients who also presented with the lowest obestatin levels (0.8 [0.30-2.7] ng/mL) when compared with HD patients and healthy volunteers. HD patients presented the highest obestatin plasma levels (3.0 [2.7-3.4] ng/mL) and the lowest acyl-ghrelin/obestatin ratio (P < .05). Obestatin levels inversely correlated with WC (r = -0.6, P < .04) and BMI (r = -0.56, P < .04) in healthy volunteers.


CONCLUSIONS
Although no correlation was found for appetite and food intake with acyl-ghrelin and obestatin in CKD patients, HD patients have the most important alteration of acyl-ghrelin and obestatin plasma levels and had a more impaired nutritional status than nondialysis CKD individuals.
Graduate Program in Medical Sciences, Fluminense Federal University, Niterói-Rio de Janeiro, Brazil. Electronic address: nat_borges_@hotmail.com.
Natália
N
Borges
Graduate Program in Cardiovascular Sciences, Fluminense Federal University, Niterói-Rio de Janeiro, Brazil.
Cristiane
C
Moraes
Graduate Program in Cardiovascular Sciences, Fluminense Federal University, Niterói-Rio de Janeiro, Brazil.
Amanda F
AF
Barros
Medicine Faculty, Fluminense Federal University, Niterói-Rio de Janeiro, Brazil.
José C
JC
Carraro-Eduardo
Department of Nephrology, Hôpital Edouard Herriot and Institut National de la Sante' et de la Recherche Médicale U870, University of Lyon 1, Lyon, France.
Denis
D
Fouque
Graduate Program in Medical Sciences, Fluminense Federal University, Niterói-Rio de Janeiro, Brazil; Graduate Program in Cardiovascular Sciences, Fluminense Federal University, Niterói-Rio de Janeiro, Brazil.
Denise
D
Mafra
D000328:Adult; D000368:Aged; D001066:Appetite / Q000502:physiology; D001827:Body Height; D015992:Body Mass Index; D001835:Body Weight; D001938:Brazil; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D004044:Dietary Proteins / Q000008:administration & dosage; D002149:Energy Intake; D005260:Female; D054439:Ghrelin / Q000097:blood*; D005919:Glomerular Filtration Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D015596:Nutrition Assessment; D009752:Nutritional Status; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000097:blood*; D055105:Waist Circumference
D004044:Dietary Proteins; D054439:Ghrelin; C505799:obestatin, human