Ghrelin levels in patients with post hepatitis C liver cirrhosis and hepatocellular carcinoma (HCC)
Nermin Sheriba, Manal Abu-Shady, Mona Abd-Elsalam, Nanice Adel, Tahany Abdelmonem & Alshimaa Hassan
Background: Anorexia is a problem of paramount importance in patients with advanced liver cirrhosis contributing to malnutrition. In turn, malnutrition is a risk factor for the development of life-threatening complications and increased mortality. Ghrelin hormone; an important orexigenic agent has been postulated to integrate anabolic changes in the body.
Aim: To assess ghrelin level in Egyptian patients with liver cirrhosis and hepatocellular carcinoma.
Method: Ghrelin levels were determined in 25 patients with post-hepatitic (HCV) liver cirrhosis, 25 patients with hepatocellular carcinoma and compared to 25 healthy controls. Ghrelin levels were correlated with the clinical and biochemical parameters.
Results: Ghrelin levels were significantly reduced in patients with post-hepatitic liver cirrhosis (52.4±14 pg/ml) unlike patients with hepatocellular carcinoma who showed markedly elevated levels (453.8±36 pg/ml). BMI was significantly low in HCC than liver cirrhosis group (22.4±2.1 vs 17.6±0.9). Ghrelin levels were significantly higher in Child C patients in both groups. There was an inverse correlation with between serum ghrelin and BMI.
Conclusion: Ghrelin levels were significantly reduced in patients with post-hepatitic liver cirrhosis in comparison to control. There was no significant difference between the liver cirrhosis and the control group in BMI. However, the low levels in liver cirrhosis group could be attributed to portal hypertension and portosystemic shunting present in the cirrhotic patients. Patients with hepatocellular carcinoma showed higher levels in serum ghrelin than the control group, this could be attributed to the markedly lowered BMI in the HCC. Ghrelin levels were significantly higher in Child C patients in both groups. There was an inverse correlation with BMI.