Panarese Alba, Romiti Alessandra, Iacovazzi Palma Aurelia, Leone Carla Maria, Pesole Pasqua Letizia, Correale Mario, Vestito Amanda, Bazzoli Franco, Zagari Rocco Maurizio
Department of Gastroenterology and Digestive Endoscopy, National Research Institute 'S. De Bellis', Castellana Grotte, Bari.
Department of Medical and Surgical Sciences, University of Bologna, Bologna.
Eur J Gastroenterol Hepatol. 2020 Oct;32(10):1335-1340. doi: 10.1097/MEG.0000000000001868.
Atrophic gastritis may affect circulating ghrelin levels and, indirectly, body mass index. The aim of this study was to investigate the relationship between atrophic gastritis, focusing on autoimmune atrophic gastritis and advanced stages of atrophic gastritis, serum ghrelin levels and BMI.
Sixty-three patients, of whom 18 had autoimmune atrophic gastritis, 27 non-autoimmune antrum and corpus atrophic gastritis, and 18 non-atrophic gastritis or antrum-limited atrophic gastritis (control group) were assessed. All participants underwent endoscopy with multiple gastric biopsies. Atrophic gastritis was diagnosed by histology, classified according to the Updated Sydney System and staged by the Operative Link on Gastritis Assessment (OLGA) Classification. Total serum ghrelin, body weight and height were measured.
Compared with control patients (144.6 ± 111 pg/ml), mean serum level of total ghrelin was higher in patients with autoimmune atrophic gastritis (226.08 ± 243.03 pg/ml, P = 0.65) and lower in those with both antrum and corpus atrophic gastritis (74.51 ± 37.38 pg/ml, P = 0.12), although differences were not statistically significant. Serum ghrelin decreased in patients with advanced OLGA stages of atrophic gastritis. In non-obese patients BMI was significantly lower in those with both antrum and corpus atrophic gastritis than in control patients (23.1 ± 1.8 vs. 24.5 ± 1.6, P = 0.01), also after adjustment for age and sex (P = 0.02); BMI was positively correlated with serum total ghrelin (r = 0.51, P < 0.001).
Advanced stages of atrophic gastritis, but not autoimmune atrophic gastritis, seem to be associated with lower serum levels of ghrelin and lower BMI. In non-obese patients, BMI was positively correlated with total serum ghrelin.
萎缩性胃炎可能影响循环中胃饥饿素水平，进而间接影响体重指数。本研究旨在探讨萎缩性胃炎（重点关注自身免疫性萎缩性胃炎和萎缩性胃炎晚期）、血清胃饥饿素水平与体重指数之间的关系。
对63例患者进行了评估，其中18例患有自身免疫性萎缩性胃炎，27例患有非自身免疫性胃窦和胃体萎缩性胃炎，18例患有非萎缩性胃炎或局限于胃窦的萎缩性胃炎（对照组）。所有参与者均接受了内镜检查及多次胃活检。通过组织学诊断萎缩性胃炎，根据更新的悉尼系统进行分类，并通过胃炎评估手术链接（OLGA）分类进行分期。测量血清总胃饥饿素、体重和身高。
与对照组患者（144.6±111 pg/ml）相比，自身免疫性萎缩性胃炎患者的血清总胃饥饿素平均水平较高（226.08±243.03 pg/ml，P = 0.65），胃窦和胃体均萎缩性胃炎患者的血清总胃饥饿素平均水平较低（74.51±37.38 pg/ml，P = 0.12），尽管差异无统计学意义。萎缩性胃炎OLGA晚期患者的血清胃饥饿素水平降低。在非肥胖患者中，胃窦和胃体均萎缩性胃炎患者的体重指数显著低于对照组患者（23.1±1.8 vs. 24.5±1.6，P = 0.01），在调整年龄和性别后也是如此（P = 0.02）；体重指数与血清总胃饥饿素呈正相关（r = 0.51，P < 0.001）。
萎缩性胃炎晚期，而非自身免疫性萎缩性胃炎，似乎与较低的血清胃饥饿素水平和较低的体重指数有关。在非肥胖患者中，体重指数与血清总胃饥饿素呈正相关。
