Significance of appetite hormone ghrelin and obestatin levels in the assessment of the severity of acute pancreatitis

Abstract

Background/Aims: Due to risk of morbidity and mortality, various tests and scoring systems used in the assessment of the diagnosis and severity of acute pancreatitis disease are gaining more importance every day. Most of the current scoring systems, validated by various parameters, have a sophisticated and complex structure. Research is ongoing to establish a method to diagnose the disease and determine the severity by using different and simple parameters. In this trial, we aimed to investigate the role of the orexigenic "ghrelin" and anorexigenic "obestatin" hormones, if any, on the diagnosis and assessment of the severity of acute pancreatitis. Materials and Methods: A total of 30 patients hospitalized between September 2009 and September 2010 with a diagnosis of acute pancreatitis (AP) and 25 healthy volunteers were enrolled in the trial with a prospective and randomized design. The patients were classified in two groups, mild (Ranson ≤3 and / or Apache II ≤8) and severe (Ranson >3 and/or Apache II >8) cases, as per the Ranson and Apache-II criteria; the ghrelin and obestatin levels in blood samples obtained from the patients were measured using the ELISA method. Results: Twenty-two of the 30 patients (73%) were regarded as mild pancreatitis cases, while 8 cases (27%) were diagnosed as severe pancreatitis. Comparison of the mild and severe pancreatitis groups did not reveal a statistical difference between the two groups in terms of acylated and de-acylated ghrelin values on presentation and following the initiation of oral feeding. Similarly, no significant difference was found in the comparison of the patient and the control groups in terms of acylated and de-acylated ghrelin values on presentation (p=0.863). On the other hand, acylated and de-acylated ghrelin values after initiation of oral feeding were observed to be higher in the patient group (p=0.001, p=0.000). Comparison of these two groups revealed a significant difference in obestatin values, both on presentation and after initiation of oral feeding (p=0.002 and p=0.000). Conclusion: Consistently high serum ghrelin values during pancreatic inflammation suggest that ghrelin may be used as an adjunctive parameter in the monitoring of the course of the disease. On the other hand, high obestatin values in patients on presentation indicate that this hormone is a more significant parameter in terms of diagnosis. However, no correlation was established between these two peptide hormones and the severity of AP.

Serum ghrelin, but not obestatin, is a potential predictor of acute pancreatitis severity

“…Several studies have shown that acute obestatin treatment and chronic treatment with native or modified obestatin can alter triglyceride levels, [ 4 , 27 ] suggesting that obestatin is involved in the lipid metabolism. In this study, serum obestatin levels in patients with AP were elevated at admission, but were not correlated with AP severity; these findings are consistent with those of Kanat et al [ 18 ] Unlike serum ghrelin levels, serum obestatin levels differed significantly between patients with AP caused by hypertriglyceridemia and those with AP of other etiologies. In addition, these patients had higher BISAP, Ranson, and MCTSI scores than did patients with AP of other etiologies, and the hypertriglyceridemia etiology group included significantly fewer patients with MAP than did the other 3 etiology groups.…”

“…[ 14 , 15 ] The administration of obestatin inhibited the development of AP in a rat model, [ 16 , 17 ] but few studies have investigated the role of endogenous obestatin in human patients with AP. [ 18 ] Thus, this study was designed to assess serum ghrelin and obestatin levels in patients with AP, and to determine whether these 2 indexes have predictive value as biomarkers in AP.…”

Obestatin as a key regulator of metabolism and cardiovascular function with emerging therapeutic potential for diabetes

“…Similarly, obestatin has been shown to protect against acute pancreatitis in rats, induced by either cerulein or ischaemia/reperfusion, via increasing pancreatic blood supply in parallel with reduced inflammation and digestive enzyme activity, and also to promote pancreatic repair and regeneration in these animals (Ceranowicz et al ., ; Bukowczan et al ., ). Indeed, circulating obestatin levels are increased in patients with acute pancreatitis (Kanat et al ., ), supporting a protective function in this setting.…”

Effects of methylphenidate on appetite and growth in children diagnosed with attention deficit and hyperactivity disorder

“…Pancreas and fatty tissue appear to be influential among the mechanisms that regulate appetite, the central nervous system, the gastrointestinal system (GIS), several anorexigenic and orexigenic peptides, and hormonal mediators released from the adrenals (1)(2)(3)(4)(5). Particular emphasis is being put on the leptin and ghrelin system in the pathophysiology of many diseases that affect appetite (6)(7)(8)(9)(10)(11).…”