Evaluation of ghrelin level and appetite regulation in patients with acute exacerbations of chronic obstructive pulmonary disease

Abstract

Background

Appetite reduction is a major cause of cachexia in acute exacerbations of chronic obstructive pulmonary disease (AECOPD). This study tested the correlation of appetite and circulating levels of acylated ghrelin in patients with AECOPD.

Methods

Thirty-six patients with AECOPD and 23 healthy adults were enrolled in this study. Circulating total ghrelin, acylated ghrelin, and obestatin levels, Simplified Nutritional Appetite Questionnaire (SNAQ) score, and caloric intake were compared in patients and healthy controls. Additionally, the above parameters were compared between admission and discharge in the patients with AECOPD.

Results

Compared with healthy controls, SNAQ scores and caloric intake were significantly lower in patients with AECOPD, but there were no significant differences in total ghrelin, acyl ghrelin, or obestatin levels. In patients with AECOPD, the total ghrelin level was significantly higher at admission than on discharge, the SNAQ score and caloric intake were significantly increased at discharge when compared with admission, and there was no significant difference in acylated ghrelin level between admission and discharge.

Conclusion

We demonstrated lower appetite scores and caloric intake in patients with AECOPD, but could not confirm that these effects were caused by insufficient levels of the orexigenic peptide, acyl ghrelin. Further studies are needed to confirm our findings and to determine the mechanism regulating appetite in patients with AECOPD.

Keywords:

• ghrelin
• appetite
• pulmonary disease
• chronic obstructive
• malnutrition
• comorbidities

Acknowledgments

This study was supported in part by grants (81300032, 31171103, and 81230001) from the National Natural Science Foundation of China, and a grant (2013SZ0001) from the Projects in the Science and Technology Pillar Program, Department of Science and Technology of Sichuan Province. The authors would like to thank Deying Kang and Shihong Zhou (West China School of Public Health, Sichuan University, Chengdu, People’s Republic of China) for help with the statistical analysis.

Disclosure

The authors report no conflicts of interest in this work.