Significance of Plasma Ghrelin and Leptin Level as Surrogate Markers for Intestinal Inflammation in Patients with Crohns Disease

Abstract

Introduction: The most important determinant of the clinical course of Crohns disease (CD) is the balance of proinflammatory, anti-inflammatory, and immunomodulating factors. Determining inflammatory activity is crucial for the assessment of disease activity and for the tailoring of therapy. Inflammatory reactions localized in the bowel wall may penetrate the surrounding visceral adipose tissue. Activated visceral adipocytes secrete many mediators, such as leptin, adiponectin, and ghrelin. The present study was designed to evaluate fasting serum levels of leptin, adiponectin, obestatin, and ghrelin in CD patients, and determine whether theses markers can be surrogate markers for intestinal inflammation and disease activity in CD patients.

Methods: From march 2009 to February 2012, we collected serum samples and analyzed the clinical features of CD patient at thirteen hospitals nationwide in Korea. Fasting leptin, adiponectin, obsestatin, and ghrelin concentrations were measured using commercially available enzyme-linked immunosorbent assay. The patients were classified on the basis of the Montreal classification and medical records were collected retrospectively. We analyzed relationship between serum adiopcytokine levels and clinical parameters of CD patients.

Results: One hundred and fifty-three CD patients were included. Serum ghrelin level was negatively correlated with patients age (p=0.041) and age at diagnosis (p=0.017), and positively correlated with CRP level (p=0.017) with statistically significance in univariate analysis. In multivariate analysis, serum ghrelin level was correlated statistically significant only with CRP level (p=0.032). Serum leptin level was also correlated with CRP level (p<0.001). The adipocytokine levels were not significantly different according to the disease location nor behavior. Serum ghrelin level was lower in surgery group than non-surgery group with statistically significant (p=0.007).

Conclusions: Our analysis showed that serum leptin and ghrelin levels can be a potential surrogate inflammatory marker for CD, and may serve as useful tools to estimate disease activity in clinical practice.