Association of Ghrelin and Resistin With Body Fat Composition and Insulin Resistance in Chronic Renal Failure | ||||
| Bulletin of Egyptian Society for Physiological Sciences | ||||
| Article 17, Volume 27, Issue 2, December 2007, Page 249-264 PDF (174.82 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/besps.2007.37381 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
| Samar Marzouk* 1; Amal El-Shehaby1; Amr Zahra1; Mohamed El-Khatib2; Naglaa Mostafa3; Soha Talaat3 | ||||
| 1Department of Medical Biochemistry, Faculty of Medicine, Cairo University | ||||
| 2Department of Internal Medicine, Faculty of Medicine, Cairo University | ||||
| 3Department of Radiology, Faculty of Medicine, Cairo University | ||||
| Abstract | ||||
| The metabolic role of the energy modulating hormone ghrelin and the adipocytokine resistin is perturbed in uremia and could contribute to nutritional abnormalities. Malnutrition is an important risk factor for mortality in uremic patients. The present study aimed to clarify the possible role of ghrelin and resistin in malnutrition observed in patients with chronic renal failure and to study their interrelationship, as well as, their correlation with body fat composition and insulin resistance. The study was performed on sixty patients and twenty control subjects matched for age, sex, and body mass index (BMI). The patients were classified into two groups: 30 patients with end-stage renal failure on chronic hemodialysis; and 30 pre-dialysis chronic renal failure patients on conservative treatment. All patients and control subjects were subjected to a thorough clinical assessment, and estimation of fasting plasma levels of lipid profile, creatinine, glucose, insulin, ghrelin and resistin. Insulin resistance was assessed using the homeostatic assessment model for insulin resistance (HOMAIR ). Body fat composition was measured in all subjects by means of dual-energy X- ray absorptiometry (DEXA). Plasma ghrelin and resistin levels were significantly higher in both hemodialysis and pre-dialysis groups compared to control subjects. Furthermore, plasma ghrelinand resistin levels weresignificantly higher in hemodialysis group compared to pre-dialysis group. In hemodialysis group, a significant negative correlation was found between plasma ghrelin and each of resistin, BMI, insulin, HOMAIR , and truncal fat mass, while a significant positive correlation between plasma ghrelin and creatinine was found. In pre-dialysis group, plasma ghrelin was inversely correlated significantly with BMI, insulin, HOMAIR , and truncal fat mass, but positively correlated significantly with creatinine and lean body mass. As regards plasma resistin, no correlation was found between resistin and any of the studied parameters in that group. In control subjects, plasma ghrelin showed significant negative correlation with BMI, and both truncal fat mass and body fat mass, but a significant positive correlation was detected between plasma ghrelin and lean body mass. However, plasma resistinwas negatively correlated significantly with truncal fat mass, body fat mass, and positively correlated significantly with lean body mass. Multiple regression analysis showed that plasma ghrelin was dependent on BMI in both hemodialysis and predialysis subjects and on truncal fat mass in control subjects In conclusion, plasma ghrelin and resistin concentration were markedly elevated in patients with end-stage renal failure, which might be caused by decreased metabolism or excretion in renal failure. The negative correlation between plasma ghrelin and fat composition and insulin suggest that anorexia causes increase in ghrelin secretion in dialysis patients, which might be a compensatory mechanism rather than a causative factor. However, the lack of association between the increased plasma resistin and fat composition and insulin resistance suggest that resistin is not likely a mediator of nutritional status and insulin resistance in patients with end-stage renal failure. | ||||
| Keywords | ||||
| ghrelin; Resistin; Insulin Resistance; end-stage renal failure | ||||
|
Statistics Article View: 114 PDF Download: 166 |
||||
