The stomach is the main source of circulating ghrelin. Plasma concent rations of this hormone in patients with various upper gastrointestinal diseases remain undetermined. Thus we measured plasma ghrelin levels by rad...The stomach is the main source of circulating ghrelin. Plasma concent rations 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 Helicob acter pylori-infected and 91 uninfected subjects. They included 67 patients with chronic gastritis (CG), 26 with benign gastric polyp (BGP), 24 with gastricul cer (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 signi ficantly 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 un differentiated GC. Ghrelin concentrations in BGP, RE, and DU patients were compa rable 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 populati ons. 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 digestiv etract, reflecting the inflammatory and atrophic events of the background gastr ic mucosa. Further investigation is warranted to unravel the mechanisms of the high circulating ghrelin levels in certain upper gastrointestinal diseases.展开更多
Background: Diabetic gastroparesis is a disabling condition with no consistently effective treatment. In animals, ghrelin increases gastric emptying and reverses postoperative ileus. We present the results of a double...Background: Diabetic gastroparesis is a disabling condition with no consistently effective treatment. In animals, ghrelin increases gastric emptying and reverses postoperative ileus. We present the results of a double blind, placebo controlled, crossover study of ghrelin in gastric emptying in patients with diabetic gastroparesis. Methods: Ten insulin requiring diabetic patients (fivemen, six type I) referred with symptoms indicative of gastroparesis received a two hour infusion of either ghrelin (5 pmol/kg/min) or saline on two occasions. Blood glucose was control led by euglycaemic clamp. Gastric emptying rate (GER) was calculated by real tim e ultrasound following a test meal. Blood was sampled for ghrelin, growth hormon e (GH), and pancreatic polypeptide (PP) levels. Cardiovagal neuropathy was asses sed using the Mayo Clinic composite autonomic severity score (range 0 (normal)- 3). Results: Baseline ghrelin levels were mean 445 (SEM 36) pmol/l. Ghrelin infu sion achieved a peak plasma level of 2786 (188) pmol/l at 90 minutes, correspond ing to a peak GH of 70.9 (19.8) pmol/l. Ghrelin increased gastric emptying in se ven of 10 patients (30 (6)%to 43 (5)%; p = 0.04). Impaired cardiovagal tone co rrelated inversely with peak postprandial PP values (p < 0.05) but did not corre late with GER. Conclusions: Ghrelin increases gastric emptying in patients with diabetic gastroparesis. This is independent of vagal tone. We propose that analo gues of ghrelin may represent a new class of prokinetic agents.展开更多
文摘The stomach is the main source of circulating ghrelin. Plasma concent rations 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 Helicob acter pylori-infected and 91 uninfected subjects. They included 67 patients with chronic gastritis (CG), 26 with benign gastric polyp (BGP), 24 with gastricul cer (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 signi ficantly 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 un differentiated GC. Ghrelin concentrations in BGP, RE, and DU patients were compa rable 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 populati ons. 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 digestiv etract, reflecting the inflammatory and atrophic events of the background gastr ic mucosa. Further investigation is warranted to unravel the mechanisms of the high circulating ghrelin levels in certain upper gastrointestinal diseases.
文摘Background: Diabetic gastroparesis is a disabling condition with no consistently effective treatment. In animals, ghrelin increases gastric emptying and reverses postoperative ileus. We present the results of a double blind, placebo controlled, crossover study of ghrelin in gastric emptying in patients with diabetic gastroparesis. Methods: Ten insulin requiring diabetic patients (fivemen, six type I) referred with symptoms indicative of gastroparesis received a two hour infusion of either ghrelin (5 pmol/kg/min) or saline on two occasions. Blood glucose was control led by euglycaemic clamp. Gastric emptying rate (GER) was calculated by real tim e ultrasound following a test meal. Blood was sampled for ghrelin, growth hormon e (GH), and pancreatic polypeptide (PP) levels. Cardiovagal neuropathy was asses sed using the Mayo Clinic composite autonomic severity score (range 0 (normal)- 3). Results: Baseline ghrelin levels were mean 445 (SEM 36) pmol/l. Ghrelin infu sion achieved a peak plasma level of 2786 (188) pmol/l at 90 minutes, correspond ing to a peak GH of 70.9 (19.8) pmol/l. Ghrelin increased gastric emptying in se ven of 10 patients (30 (6)%to 43 (5)%; p = 0.04). Impaired cardiovagal tone co rrelated inversely with peak postprandial PP values (p < 0.05) but did not corre late with GER. Conclusions: Ghrelin increases gastric emptying in patients with diabetic gastroparesis. This is independent of vagal tone. We propose that analo gues of ghrelin may represent a new class of prokinetic agents.
