Concentrations of Ghrelin and Leptin in Children with Cystic Fibrosis

Ghrelin and leptin are peptide hormones which, working antagonistically, regulate the energy balance of the body. Abnormal concentrations of these hormones are observed in the course of gastrointestinal diseases, where the clinical picture is characterized by nutritional disorders. Approximately 70% of patients with cystic fibrosis have body weight deficiency due to exocrine pancreatic insufficiency, respiratory failure, and secondary circulatory disorders as well as eating disorders. The aim of the study was to evaluate the levels of ghrelin and leptin in the blood serum of patients diagnosed with cystic fibrosis, in relation to their nutritional status and function of liver cells. Patients and methods: The study group consisted of 34 patients, 17 girls (50%) and 17 boys (50%), aged from 3 months to 18 years (mean age 4.5 years) who were diagnosed with cystic fibrosis on the basis of screening and/ or diagnostic tests. The analysis included the nutritional status (body weight and height, BMI), CFTR gene mutation, assessment of the exocrine pancreas function (albumin and glucose concentration in the blood serum, acid steatocrit in stool), abnormal lipid metabolism (cholesterol and triglyceride levels in blood serum), as well as liver cell function parameters and cholestasis (serum activity amino-transpherase, gamma-glutamyl transpeptidase, concentration of bile acids, coagulation parameters). In all children, serum ghrelin and leptin levels were measured by means of an immunoenzymatic test, using reagents from DRG Instruments. The results were statistically analyzed. Results: Serum ghrelin levels were significantly lower in the youngest patients (u003c1 year of age) compared with older age groups. Ghrelin concentration was significantly lower in patients with salt wasting syndrome (pu003c0.05). The statistically lower serum leptin levels were observed in patients with growth deficiency and increased parameters of cholestasis, particularly in the youngest age group. Conclusion: Ghrelin and leptin levels in children with cystic fibrosis correlate with the nutritional status and can be an early marker of exocrine pancreatic insufficiency.