Gündoğan Mehmet, Çalli Demırkan Neşe, Tekın Koray, Aybek Hülya
Department of Medical Pathology, Pamukkale University, Faculty of Medicine, Denizli, Turkey.
Turk Patoloji Derg. 2013;29(1):19-26. doi: 10.5146/tjpath.2013.01143.
The role of Ghrelin, also known as the appetite hormone, is not fully explained in the development of morbid obesity. Plasma Ghrelin level is low in obese and high in slim subjects. Ghrelin-expressing cells were investigated histopathologically in the stomach of morbid obese patients in this study. Tissue Ghrelin expression was also compared with various parameters such as the distribution of endocrine cells, age, gender, body mass index, preoperative plasma Ghrelin level and presence of accompanying diseases.
The study included 33 morbidly obese patients, and 8 non-obese control patients. Plasma Ghrelin levels were measured preoperatively. Sleeve gastrectomy resection materials of 33 cases were evaluated with histopathological and immunohistochemical (Ghrelin and Chromogranin-A) techniques. The results were statistically evaluated by nonparametric tests.
Histopathological findings observed in sleeve gastrectomy resection materials were interstitial lymphocytic infiltration (63.6%), hyperplasia of lymphoid follicles in the lamina propria (60.7%) and microvesiculation / dilatation of parietal cells (57.6%). The number of Ghrelin immunopositive cells in the gastric mucosa in females was significantly higher compared to males (p=0,007). Additionally, the number of Ghrelin immunopositive cells was significantly higher at the fundus-proximal corpus compared to the distal corpus of the stomach (p=0.0001). No significant correlation was found between Ghrelin-chromogranin immunopositive endocrine cell distribution and preoperative plasma Ghrelin levels and endocrine cell hyperplasia.
Our study confirms that Ghrelin producing cells are most dense in the proximal stomach. Increased number of Ghrelin expressing cells in the gastric mucosa in females compared to males suggests that gender may also be a factor in determining the method for treatment of morbid obesity.
胃饥饿素又称食欲激素，其在病态肥胖症发展过程中的作用尚未完全阐明。肥胖者血浆胃饥饿素水平较低，而苗条者血浆胃饥饿素水平较高。本研究对病态肥胖患者胃内表达胃饥饿素的细胞进行了组织病理学研究。还将组织胃饥饿素表达与各种参数进行了比较，如内分泌细胞分布、年龄、性别、体重指数、术前血浆胃饥饿素水平及伴发疾病情况。
本研究纳入了33例病态肥胖患者和8例非肥胖对照患者。术前测定血浆胃饥饿素水平。采用组织病理学和免疫组织化学（胃饥饿素和嗜铬粒蛋白A）技术对33例患者的袖状胃切除术切除材料进行评估。结果采用非参数检验进行统计学评估。
袖状胃切除术切除材料中观察到的组织病理学表现为间质淋巴细胞浸润（63.6%）、固有层淋巴滤泡增生（60.7%）和壁细胞微泡形成/扩张（57.6%）。女性胃黏膜中胃饥饿素免疫阳性细胞数量显著高于男性（p = 0.007）。此外，胃底-胃体近端的胃饥饿素免疫阳性细胞数量显著高于胃体远端（p = 0.0001）。胃饥饿素-嗜铬粒蛋白免疫阳性内分泌细胞分布与术前血浆胃饥饿素水平及内分泌细胞增生之间未发现显著相关性。
我们的研究证实，产生胃饥饿素的细胞在胃近端最为密集。女性胃黏膜中表达胃饥饿素的细胞数量多于男性，这表明性别可能也是决定病态肥胖治疗方法的一个因素。
