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Ghrelin and acyl ghrelin levels are associated with inflammatory and nutritional markers and with cardiac and vascular dysfunction parameters in hemodialysis patients

  • Crina Claudia Rusu
  • Simona Racasan
  • Diana Moldovan
  • Alina Potra
  • Dacian Tirinescu
  • Cristian Budurea
  • Remus Orasan
  • Ioan Mihai Patiu
  • Cosmina Bondor
  • Dan Vladutiu
  • Dan Delean
  • Alexandra Danu
  • Ina Maria Kacso
Nephrology - Original Paper
  • 33 Downloads

Abstract

Purpose

Exogenous ghrelin is associated with cardiovascular protection in experimental and human studies. Nevertheless ESRD patients have increased ghrelin levels and severe cardiovascular comorbidities. This study aims to elucidate the metabolic factors influencing endogenous ghrelin/acyl ghrelin levels and to analyze the relation between endogenous ghrelin/acyl ghrelin levels and cardiac and vascular function markers in hemodialysis patients.

Methods

The cross-sectional study was conducted in hemodialysis patients (n = 88); 50 of them were men, mean age 61.1 ± 13.5 years, 17% had diabetes. We assessed nutritional and inflammatory status and analyzed the determinants of ghrelin/acyl ghrelin and their relation with cardiac and vascular function.

Results

Ghrelin is correlated with IL-1β (r = 0.88, p < 0.0001), triglycerides, total cholesterol (TC), and Kt/V. IL-1β is the strongest predictor of ghrelin levels (p < 0.0001). Acyl ghrelin is correlated with TC (r = 0.36, p = 0.001), LDL-cholesterol, serum bicarbonate, body mass index. TC is the strongest predictor for acyl ghrelin levels (p = 0.038). Patients with high ghrelin levels had significantly decreased nitroglycerin-mediated dilation (p = 0.05) and higher IL-1β levels (p < 0.001); increased NT-proBNP is associated with lower levels of acyl ghrelin (r = − 0.33, p = 0.02) in male patients.

Conclusion

The inflammatory marker IL-1β is in our study the strongest predictor of ghrelin levels while the nutritional marker-total cholesterol is the strongest predictor for acyl ghrelin levels in HD patients. High endogenous ghrelin level is associated with high IL-1β and with vascular smooth muscle cell dysfunction. Low acyl ghrelin level is associated with high NT-proBNP (a cardiac dysfunction marker) in male HD patients. There is a direct correlation between endogenous ghrelin level and inflammatory markers, which is not related with cardiovascular protection.

Keywords

Ghrelin IL-1β Nutritional status Inflammation Cardiovascular disease Chronic kidney failure 

Notes

Compliance with ethical standards

Conflict of interest

The authors report no conflict of interest.

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Copyright information

© Springer Nature B.V. 2018

Authors and Affiliations

  • Crina Claudia Rusu
    • 1
  • Simona Racasan
    • 2
  • Diana Moldovan
    • 1
  • Alina Potra
    • 1
  • Dacian Tirinescu
    • 1
  • Cristian Budurea
    • 2
  • Remus Orasan
    • 2
  • Ioan Mihai Patiu
    • 2
  • Cosmina Bondor
    • 3
  • Dan Vladutiu
    • 1
  • Dan Delean
    • 2
  • Alexandra Danu
    • 4
  • Ina Maria Kacso
    • 1
  1. 1.Department of NephrologyUniversity of Medicine and Pharmacy “Iuliu Hatieganu” ClujCluj-NapocaRomania
  2. 2.Nefromed Dialysis CenterCluj-NapocaRomania
  3. 3.Department of Informatics and BiostatisticsUniversity of Medicine and Pharmacy “Iuliu Hatieganu” ClujCluj-NapocaRomania
  4. 4.Nephrocare Dialysis Center DejDejRomania

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