Iglesias Pedro, Díez Juan J, Fernández-Reyes María J, Codoceo Rosa, Alvarez-Fidalgo Pilar, Bajo María A, Aguilera Abelardo, Selgas Rafael
Department of Endocrinology, Hospital General de Segovia, Spain.
Clin Endocrinol (Oxf). 2006 Jan;64(1):68-73. doi: 10.1111/j.1365-2265.2005.02418.x.
Ghrelin is a recently discovered protein hormone mainly synthesized in the gastric endocrine cells. This hormone not only is a potent growth hormone secretagogue but also is involved in the regulation of food ingestion and energy metabolism. Derangements in ghrelin secretion in patients with chronic renal failure (CRF) have not been fully evaluated.
Our aim has been to quantify serum concentrations of total ghrelin in a group of patients with CRF on chronic therapy with both haemodialysis (HD) and peritoneal dialysis (PD) in comparison with a group of patients on conservative management (predialysis).
We studied 68 CRF patients treated by HD (n = 30, 16 men, age 61.2 +/- 1.8 years) and PD groups (n = 38, 21 men, age 54.4 +/- 1.7 years). A group of 19 uraemic patients on conservative management served as the control. Serum concentrations of ghrelin, leptin, insulin, IGF I and GH were measured in all subjects.
Patients undergoing HD showed similar concentrations of ghrelin in comparison with the control group (9491 +/- 787 vs 9280 +/- 918 pg/ml, NS). However, PD patients exhibited baseline ghrelin concentrations significantly lower than those found in patients on conservative management (3230 +/- 216 pg/ml, P < 0.0001). Men and women showed similar serum ghrelin levels in both HD (9845.9 +/- 1071 vs 9085 +/- 1194 pg/ml) and PD patients (3214 +/- 297 vs 3250 +/- 324 pg/ml). Hypertension and diabetes mellitus did not influence ghrelin levels. Serum GH levels were positively correlated with serum ghrelin concentrations in both HD (r = 0.46, P < 0.05) and PD (r = 0.53, P < 0.001) patients; however, no relationships between ghrelin, leptin, insulin and IGF I were found.
These results suggest that PD is accompanied by a striking decrement in baseline ghrelin concentrations in comparison with values found both in HD and control patients. Further studies are necessary to determine mechanisms involved in ghrelin regulation in uraemic patients.
胃饥饿素是一种最近发现的蛋白质激素，主要在胃内分泌细胞中合成。这种激素不仅是一种强效的生长激素促分泌素，还参与食物摄入和能量代谢的调节。慢性肾衰竭（CRF）患者胃饥饿素分泌紊乱尚未得到充分评估。
我们的目的是对一组接受血液透析（HD）和腹膜透析（PD）长期治疗的CRF患者的血清总胃饥饿素浓度进行定量，并与一组接受保守治疗（透析前）的患者进行比较。
我们研究了68例接受HD治疗的CRF患者（n = 30，男性16例，年龄61.2±1.8岁）和PD组（n = 38，男性21例，年龄54.4±1.7岁）。一组19例接受保守治疗的尿毒症患者作为对照。测量了所有受试者的血清胃饥饿素、瘦素、胰岛素、IGF-I和生长激素（GH）浓度。
与对照组相比，接受HD治疗的患者胃饥饿素浓度相似（9491±787 vs 9280±918 pg/ml，无显著性差异）。然而，PD患者的基线胃饥饿素浓度显著低于接受保守治疗的患者（3230±216 pg/ml，P < 0.0001）。HD患者（9845.9±1071 vs 9085±1194 pg/ml）和PD患者（3214±297 vs 3250±324 pg/ml）中男性和女性的血清胃饥饿素水平相似。高血压和糖尿病不影响胃饥饿素水平。HD患者（r = 0.46，P < 0.05）和PD患者（r = 0.53，P < 0.001）的血清GH水平与血清胃饥饿素浓度呈正相关；然而，未发现胃饥饿素、瘦素、胰岛素和IGF-I之间存在关联。
这些结果表明，与HD患者和对照患者相比，PD患者的基线胃饥饿素浓度显著降低。需要进一步研究以确定尿毒症患者胃饥饿素调节的相关机制。
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