title: A possible role for ghrelin, leptin, brain-derived neurotrophic factor and docosahexaenoic acid in reducing the quality of life of coeliac disease patients following a gluten-free diet.
abstract: OBJECTIVE
  A gluten-free diet (GFD) has been reported to negatively impact the quality of life (QoL) of coeliac disease (CD) patients. The gut-brain axis hormones ghrelin and leptin, with the brain-derived neurotrophic factor (BDNF), may affect QoL of CD patients undergoing GFD. Our aims were to evaluate whether: (a) the circulating concentrations of leptin, ghrelin and BDNF in CD patients were different from those in healthy subjects; (b) GFD might induce changes in their levels; (c) BDNF Val66Met polymorphism variability might affect BDNF levels; and (d) serum BDNF levels were related to dietary docosahexaenoic acid (DHA) as a neurotrophin modulator.
  
  
  METHODS
  Nineteen adult coeliac patients and 21 healthy controls were included. A QoL questionnaire was administered, and serum concentrations of ghrelin, leptin, BDNF and red blood cell membrane DHA levels were determined at the enrolment and after 1 year of GFD. BDNF Val66Met polymorphism was analysed.
  
  
  RESULTS
  Results from the questionnaire indicated a decline in QoL after GFD. Ghrelin and leptin levels were not significantly different between groups. BDNF levels were significantly (p = 0.0213) lower in patients after GFD (22.0 ± 2.4 ng/ml) compared to controls (31.2 ± 2.2 ng/ml) and patients at diagnosis (25.0 ± 2.5 ng/ml). BDNF levels correlated with DHA levels (p = 0.008, r = 0.341) and the questionnaire total score (p = 0.041, r = 0.334).
  
  
  CONCLUSIONS
  Ghrelin and leptin seem to not be associated with changes in QoL of patients undergoing dietetic treatment. In contrast, a link between BDNF reduction and the vulnerability of CD patients to psychological distress could be proposed, with DHA representing a possible intermediate.
authors.affiliation: Laboratory of Nutritional Pathophysiology, National Institute for Digestive Diseases I.R.C.C.S. "Saverio de Bellis", Via Turi 27, 70013, Castellana Grotte, Bari, Italy. francesco.russo@irccsdebellis.it.
authors.forename: Francesco
authors.initials: F
authors.lastname: Russo
authors.affiliation: Department of Biosciences, Biotechnology and Biopharmaceutics, University of Bari, Bari, Italy.
authors.forename: Guglielmina
authors.initials: G
authors.lastname: Chimienti
authors.affiliation: Laboratory of Nutritional Pathophysiology, National Institute for Digestive Diseases I.R.C.C.S. "Saverio de Bellis", Via Turi 27, 70013, Castellana Grotte, Bari, Italy.
authors.forename: Caterina
authors.initials: C
authors.lastname: Clemente
authors.affiliation: Consiglio Nazionale delle Ricerche (CNR), ISOF Bio Free Radicals, Bologna, Italy.
authors.forename: Carla
authors.initials: C
authors.lastname: Ferreri
authors.affiliation: Laboratory of Nutritional Pathophysiology, National Institute for Digestive Diseases I.R.C.C.S. "Saverio de Bellis", Via Turi 27, 70013, Castellana Grotte, Bari, Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: Orlando
authors.affiliation: Laboratory of Nutritional Pathophysiology, National Institute for Digestive Diseases I.R.C.C.S. "Saverio de Bellis", Via Turi 27, 70013, Castellana Grotte, Bari, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Riezzo
mesh_terms: D000328:Adult; D000483:Alleles; D019943:Amino Acid Substitution; D019208:Brain-Derived Neurotrophic Factor / Q000097:blood / Q000235:genetics*; D016022:Case-Control Studies; D002446:Celiac Disease / Q000097:blood / Q000178:diet therapy* / Q000235:genetics* / Q000503:physiopathology; D003967:Diarrhea / Q000209:etiology / Q000517:prevention & control; D055050:Diet, Gluten-Free / Q000009:adverse effects* / Q000523:psychology; D004281:Docosahexaenoic Acids / Q000097:blood*; D004910:Erythrocyte Membrane / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D005787:Gene Frequency; D056726:Genetic Association Studies; D054439:Ghrelin / Q000097:blood; D006579:Heterozygote; D006801:Humans; D007558:Italy; D020738:Leptin / Q000097:blood; D008297:Male; D020641:Polymorphism, Single Nucleotide; D011446:Prospective Studies; D011788:Quality of Life; D013315:Stress, Psychological / Q000209:etiology
chemical_list: D019208:Brain-Derived Neurotrophic Factor; C515349:GHRL protein, human; D054439:Ghrelin; D020738:Leptin; D004281:Docosahexaenoic Acids; C579455:BDNF protein, human
keywords: BDNF; Coeliac disease; DHA; Ghrelin; Gluten-free diet; Leptin; Psychological distress