Isomoto Hajime, Ueno Hiroaki, Nishi Yoshito, Yasutake Toru, Tanaka Kenji, Kawano Naoko, Ohnita Ken, Mizuta Yohei, Inoue Kenichiro, Nakazato Masamitsu, Kohno Shigeru
Second Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki, Japan.
Dig Dis Sci. 2005 May;50(5):833-8. doi: 10.1007/s10620-005-2648-z.
The stomach is the main source of circulating ghrelin. Plasma concentrations of this hormone in patients with various upper gastrointestinal diseases remain undetermined. Thus we measured plasma ghrelin levels by radioimmunoassay in 225 subjects, including 134 Helicobacter pylori-infected and 91 uninfected subjects. They included 67 patients with chronic gastritis (CG), 26 with benign gastric polyp (BGP), 24 with gastric ulcer (GU), 24 with reflux esophagitis (RE), 18 with duodenal ulcer (DU), 28 with acute gastritis (AG), 23 with gastric cancer (GC), and 39 who had normal mucosa on upper endoscopy (N). Plasma pepsinogen I and II levels were also measured. The extent of gastritis was assessed endoscopically. Ghrelin levels differed significantly among the different disease groups. Plasma ghrelin concentrations were lowest in the CG group, followed by the GU group, and highest in the AG patients. There was a significant difference in the levels between differentiated and undifferentiated GC. Ghrelin concentrations in BGP, RE, and DU patients were comparable to those in the N group. Ghrelin circulating levels were lower in H. pylori-positive than -negative individuals, but the significant differences among disease groups were still observed in H. pylori-infected and uninfected populations. Ghrelin concentrations correlated positively with plasma pepsinogen I levels and I/II ratios and inversely with the extent of H. pylori-related gastritis. Plasma ghrelin levels varied widely in diverse conditions of the upper digestive tract, reflecting the inflammatory and atrophic events of the background gastric mucosa. Further investigation is warranted to unravel the mechanisms of the high circulating ghrelin levels in certain upper gastrointestinal diseases.
胃是循环中胃饥饿素的主要来源。各种上消化道疾病患者体内这种激素的血浆浓度仍未明确。因此，我们采用放射免疫分析法测量了225名受试者的血浆胃饥饿素水平，其中包括134名幽门螺杆菌感染患者和91名未感染患者。他们包括67例慢性胃炎（CG）患者、26例胃良性息肉（BGP）患者、24例胃溃疡（GU）患者、24例反流性食管炎（RE）患者、18例十二指肠溃疡（DU）患者、28例急性胃炎（AG）患者、23例胃癌（GC）患者以及39例上消化道内镜检查黏膜正常（N）者。同时还测量了血浆胃蛋白酶原I和II水平。通过内镜评估胃炎的程度。不同疾病组之间的胃饥饿素水平存在显著差异。CG组血浆胃饥饿素浓度最低，其次是GU组，AG患者中最高。分化型和未分化型GC之间的水平存在显著差异。BGP、RE和DU患者的胃饥饿素浓度与N组相当。幽门螺杆菌阳性个体的循环胃饥饿素水平低于阴性个体，但在幽门螺杆菌感染和未感染人群中，疾病组之间仍存在显著差异。胃饥饿素浓度与血浆胃蛋白酶原I水平和I/II比值呈正相关，与幽门螺杆菌相关性胃炎的程度呈负相关。上消化道不同状况下血浆胃饥饿素水平差异很大，反映了背景胃黏膜的炎症和萎缩情况。有必要进一步研究以阐明某些上消化道疾病中循环胃饥饿素水平升高的机制。
