Skip to main content

Advertisement

SpringerLink
Log in

Circulating Ghrelin Levels in Patients with Various Upper Gastrointestinal Diseases

  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Kojima M, Hosoda H, Date Y, Nakazato M, Matsuo H, Kangawa K: Ghrelin is a growth hormone-releasing acylated peptide from stomach. Nature 402:656–660, 1999

    Article  CAS  PubMed  Google Scholar 

  2. Murray CD, Kamm MA, Bloom SR, Emmanuel AV: Ghrelin for the gastroenterologists: history and potential. Gastroenterology 125:1492–1502, 2003

    Article  CAS  PubMed  Google Scholar 

  3. St-Pierre DH, Wang L, Tache Y: Ghrelin: a novel player in the gut-brain regulation of growth hormone and energy balance. News Physiol Sci 18:242–246, 2003

    CAS  PubMed  Google Scholar 

  4. Date Y, Kojima M, Hosoda H, Sawaguchi A, Mondal MS, Suganuma T, Matsukura S, Kangawa K, Nakazato M: Ghrelin, a novel growth hormone-releasing acylated peptide, is synthesized in a distinct endocrine cell type in the gastrointestinal tracts of rats and humans. Endocrinology 141:4255–4261, 2000

    Article  CAS  PubMed  Google Scholar 

  5. Blaser MJ: Helicobacter pylori and the pathogenesis of gastroduodenal inflammation. J Infect Dis 161:626–633, 1990

    CAS  PubMed  Google Scholar 

  6. Ernst PB, Gold BD: The disease spectrum of Helicobacter pylori: the immunopathogenesis of gastroduodenal ulcer and gastric cancer. Annu Rev Microbiol 54:615–640, 2000

    Article  CAS  PubMed  Google Scholar 

  7. Borch K, Skarsgard J, Franzen L, Mardh SR, Ehfeld JF: Benign gastric polyps. Dig Dis Sci 48:1292–1297, 2003

    Article  CAS  PubMed  Google Scholar 

  8. Labenz J, Blum AL, Bayerdorffer E, Meining A, Stolte M, Borsch G: Curing Helicobacter pylori infection in patients with duodenal ulcer may provoke reflux esophagitis. Gastroenterology 112:1442–1447, 1997

    CAS  PubMed  Google Scholar 

  9. O’Connor HJ. Review article: Helicobacter pylori and gastro-esophageal reflux disease-clinical implications and management. Aliment Pharmacol Ther 13:117–127, 1999

    Article  CAS  PubMed  Google Scholar 

  10. Gokcel A, Gumurdulu Y, Kayaselcuk F, Serin E, Ozer B, Ozsahin AK, Guvener N: Helicobacter pylori has no effect on plasma ghrelin levels. Eur J Endocrinol 148:423–426, 2003

    Article  CAS  PubMed  Google Scholar 

  11. Isomoto H, Nakazato M, Ueno H, Date Y, Nishi Y, Mukae H, Mizuta Y, Ohtsuru A, Yamashita S, Kohno S: Low plasma ghrelin levels in patients with Helicobacter pylori-associated gastritis. Am J Med 117:429–432, 2004

    Article  CAS  PubMed  Google Scholar 

  12. Broutet N, Plebani M, Sakarovitch C, Sipponen P, Megraud F: Eurohepygast Study Group: Pepsinogen A, pepsinogen C and gastrin as markers of atrophic chronic gastritis in European dyspeptics. Br J Cancer 88:1239–1247, 2003

    Article  CAS  PubMed  Google Scholar 

  13. Korstanje A, den Hartog G, Biemond I, Lamers BHW: The serological gastric biopsy: a non-endoscopical diagnostic approach in management of the dyspeptic patient. Scand J Gastroenterol 37:22–26, 2002

    Article  Google Scholar 

  14. Isomoto H, Inoue K, Furusu H, Nishiyama H, Shikuwa S, Omagari K, Mizuta Y, Murase K, Murata I, Kohno S: Lafutidine, a novel histamine H2-receptor antagonist, vs lansoprazole in combination with amoxicillin and clarithromycin for eradication of Helicobacter pylori. Helicobacter 8:111–119, 2003

    Article  CAS  PubMed  Google Scholar 

  15. Price AB: The Sydney system; histological division. J Gastroenterol Hepatol 6:209–222, 1991

    CAS  PubMed  Google Scholar 

  16. Ariyasu H, Takaya K, Tagami T, Ogawa Y, Hosoda K, Akamizu T, Suda M, Koh T, Natsui K, Toyooka S, Shirakami G, Usui T, Shimatsu A, Doi K, Hosoda H, Kojima M, Kangawa K, Nakao K: Stomach is a major source of circulating ghrelin, and feeding state determines plasma ghrelin-like immunoreactivity levels in humans. J Clin Endocrinol Metab 86:2753–2758, 2001

    Article  Google Scholar 

  17. Cummings DE, Weigle DS, Frayo RS, Breen PA, Ma MK, Dellinger EP, Purnell JQ: Plasma ghrelin levels after diet-induced weight loss or gastric bypass surgery. N Engl J Med 346:1623–1630, 2002

    Article  PubMed  Google Scholar 

  18. Nwokolo CU, Freshwater DA, O’Hare P, Randeva HS: Plasma ghrelin following cure of Helicobacter pylori. Gut 52:637–640, 2003

    Article  CAS  PubMed  Google Scholar 

  19. Suzuki H, Masaoka T, Hosoda H, Ota T, Minegishi Y, Nomura S, Kangawa K, Ishii H: Helicobacter pylori infection modified gastric and plasma ghrelin dynamics in Mongolian gerbils. Gut 53:187–194, 2004

    Article  CAS  PubMed  Google Scholar 

  20. Honda S, Fujioka T, Tokieda M, Gotoh T, Nishizono A, Nasu M: Gastric ulcer, atrophic gastritis, and intestinal metaplasia caused by Helicobacter pylori infection in Mongolian gerbils. Scand J Gastroenterol 33:454–460, 1998

    Article  CAS  PubMed  Google Scholar 

  21. Cummings DE, Purnell JQ, Frayo RS, Schmidova K, Wisse BE, Weigle DS: A preprandial rise in plasma ghrelin levels suggests a role in meal initiation in humans. Diabetes 50:1714–1719, 2001

    CAS  PubMed  Google Scholar 

  22. Shimizu Y, Nagaya N, Isobe T, Imazu M, Okumura H, Hosoda H, Kojima M, Kangawa K, Kohno N: Increased plasma ghrelin level in lung cancer cachexia. Clin Cancer Res 9:774–778, 2003

    CAS  PubMed  Google Scholar 

  23. Asakawa A, Inui A, Kaga T, Yuzuriha H, Nagata T, Fujimiya M, Katsuura G, Makino S, Fujino MA, Kasuga M: Arole of ghrelin in neuroendocrine and behavioral responses to stress in mice. Neuroendocrinology 74:143–147, 2001

    Article  CAS  PubMed  Google Scholar 

  24. Arosio M, Ronchi CL, Gebbia C, Cappiello V, Beck-Peccoz P, Peracchi M: Stimulatory effects of ghrelin on circulating somatostatin and pancreatic polypeptide levels. J Clin Endocrinol Metab 88:701–704, 2003

    Article  CAS  PubMed  Google Scholar 

  25. Dornonville de la Cour C, Bjorkqvist M, Sandvik AK, Bakke I, Zhao CM, Chen D, Hakanson R: A-like cells in the rat stomach contain ghrelin and do not operate under gastrin control. Regul Pept 99:141–150, 2001

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Second Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki

    Hajime Isomoto MD, Yoshito Nishi MD, Naoko Kawano MD, Ken Ohnita MD, Yohei Mizuta MD & Shigeru Kohno MD, PhD

  2. First Department of Surgery, Nagasaki University School of Medicine, Nagasaki

    Toru Yasutake MD, PhD & Kenji Tanaka MD, PhD

  3. Third Department of Internal Medicine, Miyazaki Medical College, Miyazaki

    Hiroaki Ueno MD, PhD & Masamitsu Nakazato MD, PhD

  4. Third Department of Internal Medicine, Sunkaikai Inoue Hospital, Nagasaki, Japan

    Kenichiro Inoue MD

  5. Gastrointestinal Unit, Massachusetts General Hospital, Department of Medicine, Harvard Medical School, Jackson 706, 55 Fruit Street, Boston, Massachusetts, 02114, USA

    Hajime Isomoto MD

Authors
  1. Hajime Isomoto MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hiroaki Ueno MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yoshito Nishi MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Toru Yasutake MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kenji Tanaka MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Naoko Kawano MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Ken Ohnita MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Yohei Mizuta MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Kenichiro Inoue MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Masamitsu Nakazato MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Shigeru Kohno MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hajime Isomoto MD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Isomoto, H., Ueno, H., Nishi, Y. et al. Circulating Ghrelin Levels in Patients with Various Upper Gastrointestinal Diseases. Dig Dis Sci 50, 833–838 (2005). https://doi.org/10.1007/s10620-005-2648-z

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10620-005-2648-z

Key Words

Search

Navigation