Ghrelin, leptin and insulin in cirrhotic children and adolescents: relationship with cirrhosis severity and nutritional status.

Abstract

OBJECTIVE:

Ghrelin, leptin, and insulin concentrations are involved in the control of food intake and they seem to be associated with anorexia-cachexia in cirrhotic patients. The present study aimed to investigate the relationship between the nutritional status and fasting ghrelin, leptin and insulin concentrations in pediatric cirrhotic patients.

METHODS:

Thirty-nine patients with cirrhosis and 39 healthy controls aged 0-15 years matched by sex and age were enrolled. Severity of liver disease was assessed by Child-Pugh classification, and Pediatric for End Stage Liver Disease (PELD) or Model for End-stage Liver Disease (MELD) scores. Blood samples were collected from patients and controls to assay total ghrelin, acyl ghrelin, leptin and insulin by using a commercial ELISA kit. Anthropometry parameters used were standard deviation score of height-for-age and triceps skinfold thickness-for-age ratio. A multiple linear regression analysis was used to determine the correlation between dependent and independent variables.

RESULTS:

Acyl ghrelin was significantly lower in cirrhotic patients than in controls [142 (93-278) pg/mL vs 275 (208-481) pg/mL, P=0.001]. After multiple linear regression analysis, total ghrelin and acyl ghrelin showed an inverse correlation with age; acyl ghrelin was associated with the severity of cirrhosis and des-acyl ghrelin with PELD or MELD scores ≥15. Leptin was positively correlated with gender and anthropometric parameters. Insulin was not associated with any variable.

CONCLUSION:

Low acyl ghrelin and high des-acyl ghrelin concentrations were associated with cirrhosis severity, whereas low leptin concentration was associated with undernourishment in children and adolescents with cirrhosis.

• Authors: Cristina T L Dornelles, Helena A S Goldani, Maria Inês A Wilasco, Rafael L Maurer, Carlos O Kieling, Marilene Porowski, Cristina T Ferreira, Jorge L Santos, Sandra M G Vieira, Themis R Silveira
• Journal: Regulatory peptides (Regul Pept) Vol. 180 Pg. 26-32 (Jan 10 2013) ISSN: 1873-1686 [Electronic] Netherlands
• PMID: 23142314 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2012 Elsevier B.V. All rights reserved.

Chemical References

• Ghrelin
• Insulin
• Leptin

Topics

• Adolescent
• Case-Control Studies
• Child
• Child, Preschool
• Fasting
• Female
• Ghrelin (blood)
• Humans
• Infant
• Infant, Newborn
• Insulin (blood)
• Leptin (blood)
• Liver Cirrhosis (blood, physiopathology)
• Male
• Nutritional Status
• Severity of Illness Index