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Relationship between ghrelin, Helicobacter pylori and gastric mucosal atrophy in hemodialysis patients

World Journal of Gastroenterology 2016年第47期22卷 10440-10449页

作者： Hitomi Ichikawa Mitsushige Sugimoto Yukitoshi sakao Shu Sahara Naro Ohashi Akihiko Kato Ken Sugimoto Takahisa Furuta Akira Andoh tadashi sakao Hideo Yasuda First Department of Medicine Hamamatsu University School of Medicine Hamamastsu Shizuoka 431-3192 Japan Division of Digestive Endoscopy Shiga University of Medical Science Hospital Otsu Shiga 520-2192 Japan Hamana Clinic Hamana Clinic Hamamatsu Shizuoka 434-0037 Japan Blood Purification Unit Hamamatsu University School of Medicine Hamamastsu Shizuoka 431-3192 Japan Center for Clinical Research Hamamatsu University School of Medicine Hamamastsu Shizuoka 431-3192 Japan Department of Gastroenterology Shiga University of Medical Science HospitalOtsu Shiga 520-2192 Japan

AIM To investigate the relationship between plasma ghrelin level, Helicobacter pylori(H. pylori) infection status and the severity of atrophy in hemodialysis *** One hundred eights patients who received hemodialysis and 13 non-hemodialysis H. pylori-negative controlsunderwent gastroduodenoscopy to evaluate the severity of gastric atrophy. Serum levels of pepsinogen(PG) were measured as serum markers of gastric atrophy. H. pylori infection was evaluated by anti-H. pylori IgG antibody, rapid urease test and culture test. We classified H. pylori infection status as non-infection, present infection and past infection. In addition, plasma acyl-ghrelin and desacyl-ghrelin levels were measured by enzyme-linked immunosorbent assay. RESULTS Infection rate of H. pylori was 45.4%(49/108). Acylghrelin level in the non-infection group(39.4 ± 23.0 fmol/ml) was significantly higher than in the past(23.4 ± 19.9 fmol/ml, P = 0.005) and present infection groups(19.5 ± 14.0 fmol/ml, P < 0.001). Furthermore, desacyl-ghrelin level in the non-infection group(353.2 ± 190.2 fmol/ml) was significantly higher than those in the past(234.9 ± 137.5 fmol/ml, P = 0.008) and present infection groups(211.8 ± 124.2 fmol/ml, P < 0.001). Acyl-ghrelin was positively correlated with the PG Ⅰ level and PG Ⅰ/Ⅱ ratio(|R| = 0.484, P < 0.001 and |R| = 0.403, P < 0.001, respectively). Both ghrelins were significantly decreased in accordance with the progress of endoscopic atrophy(both P < 0.001) and acyl-ghrelin was significantly lower in patients with mild, moderate and severe atrophy(24.5 ± 23.1 fmol/ml, 20.2 ± 14.9 fmol/ml and 18.3 ± 11.8 fmol/ml) than in those with non-atrophy(39.4 ± 22.2 fmol/ml, P = 0.039, P = 0.002 and P < 0.001, respectively).CONCLUSION In hemodialysis patients, plasma ghrelin level was associated with the endoscopic and serological severity of atrophy related to H. pylori infection.

关键词： Acyl-ghrelin Desacyl-ghrelin Helicobacter pylori Hemodialysis Pepsinogen

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