title: Evaluation of malnutrition with blood ghrelin and fecal elastase levels in acute decompensated heart failure patients.
abstract: OBJECTIVE
  Exocrine pancreatic dysfunction may contribute to malnutrition and lack of appetite in the advanced stages of heart failure. Nutritional assessment was carried out on patients diagnosed with mild or moderate/severe heart failure. Fecal elastase levels are an indicator of pancreatic exocrine function and ghrelin is an appetite hormone which is also investigated for its contribution to malnutrition.
  
  
  METHODS
  This is an observational study. 52 patients (32 males, 20 females) aged over eighteen years and hospitalized for acute decompensated heart failure (ADHF) were included in the study. They were compared with 31 people (16 male, 15 female) of the same age as Control Group (C). Patients in New York Heart Association (NYHA) stages 1 and 2 were grouped as mild (miADHF), while those in NYHA stages 3 and 4 were grouped as moderate/severe ADHF (seADHF). Fecal and blood samples were taken at admission. In ADHF patients, exocrine pancreatic functions and their relationship with malnutrition were evaluated. Statistical analyses were performed using Tukey's test, the independent-sample t-test, the Kruskal-Wallis test, the Mann-Whitney U-test, the chi-square test and Pearson's bivariate correlation analysis.
  
  
  RESULTS
  Significantly decreased fecal elastase levels were found when moderate/severe ADHF patients and the control group were compared. (C 278.9±144.8, miADHF 336.6±181.7, seADHF 168.7±153.6, p=0.002). 10 seADHF patients (50%) had severe, 4 (20%) moderate, and 6 (30%) mild pancreatic insufficiency. Ghrelin levels were higher in seADHF patients compared to C and miADHF patients (C 69.7±34.6, miCHF 82.5±48.2, SeADHF 105.0±78.1 p=0.361).
  
  
  CONCLUSIONS
  Fecal elastase and ghrelin hormone levels can contribute to the determination of malnutrition in ADHF patients.
authors.affiliation: Department of Internal Medicine, Okmeydanı Training and Research Hospital, İstanbul, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Özcan
authors.affiliation: Department of Internal Medicine, Okmeydanı Training and Research Hospital, İstanbul, Turkey.
authors.forename: Güzin Zeren
authors.initials: GZ
authors.lastname: Öztürk
authors.affiliation: Department of Internal Medicine, İstanbul University, İstanbul Faculty of Medicine, İstanbul, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Köse
authors.affiliation: Department of Cardiology, İstanbul University, İstanbul Faculty of Medicine, İstanbul, Turkey.
authors.forename: Samim
authors.initials: S
authors.lastname: Emet
authors.affiliation: Department of Internal Medicine, Okmeydanı Training and Research Hospital, İstanbul, Turkey.
authors.forename: Şengül
authors.initials: Ş
authors.lastname: Aydın
authors.affiliation: Department of Internal Medicine, Okmeydanı Training and Research Hospital, İstanbul, Turkey.
authors.forename: Kadem
authors.initials: K
authors.lastname: Arslan
authors.affiliation: Department of Internal Medicine, Okmeydanı Training and Research Hospital, İstanbul, Turkey.
authors.forename: Yücel
authors.initials: Y
authors.lastname: Arman
authors.affiliation: Department of Internal Medicine, İstanbul University, İstanbul Faculty of Medicine, İstanbul, Turkey.
authors.forename: Vakur
authors.initials: V
authors.lastname: Akkaya
authors.affiliation: Department of Internal Medicine, İstanbul University, İstanbul Faculty of Medicine, İstanbul, Turkey.
authors.forename: Tufan
authors.initials: T
authors.lastname: Tükek
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000378:metabolism; D005243:Feces / Q000201:enzymology*; D005260:Female; D054439:Ghrelin / Q000097:blood*; D006333:Heart Failure / Q000097:blood / Q000378:metabolism*; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000097:blood / Q000201:enzymology / Q000209:etiology / Q000378:metabolism*; D008875:Middle Aged; D010196:Pancreatic Elastase / Q000378:metabolism*
chemical_list: D015415:Biomarkers; D054439:Ghrelin; D010196:Pancreatic Elastase