肝硬化患者胃黏膜ghrelin表达及其临床意义

研究肝硬化患者胃黏膜ghrelin表达及其意义.选择肝硬化患者36例和内镜下胃黏膜大致正常者15例为对照组,测定肱三头肌皮褶厚度(triceps skinfold thickness,TSF)、血糖、胰岛素,进行食欲评价.肝硬化组胃黏膜表达ghrelin阳性细胞面积显著高于对照组(P＜0.001),且随着Child-Pugh分级增高有递增趋势.肝硬化组空腹血糖、胰岛素均显著高于对照组(P＜0.001,P＜0.05);胰岛素敏感指数(insulin sensitivity index,ISI)显著低于对照组(P＜0.05).肝硬化组ghrelin阳性细胞面积与食欲(r=-0.432)、TSF(r=-0.525)、ISI(r=-0.509)呈负相关(P＜0.05),与血糖(r=0.449)呈正相关(P＜0.05).肝硬化时ghrelin表达增高是机体对能量负平衡状态的一种适应性反应.胃黏膜ghrelin高表达可能参与了肝硬化患者的胰岛素抵抗作用.

Expression and clinical significance of ghrelin in gastric mucosa of patients with hepatic cirrhosis

To investigate the expression and clinical significance of ghrelin in gastric mucosa of liver cirrhotic patients.36 patients with liver cirrhosis and 15 control subjects with negative endoscope were enrolled in this study.Triceps skinfold thickness(TSF),serum glucose,insulin and appetite evaluation were analyzed.The percentage of ghrelin-positive cells in gastric mucosa of liver cirrhotic patients was significantly higher than that of controls(P<0.05).With Child-pugh classification higher,the percentage became higher too.Levels of fasting serum glucose and insulin in liver cirrhotic patients were much higher than those in controls(P<0.001,P<0.05).Insulin sensitivity index(ISI) in patients with cirrhosis decreased significantly compared with that in controls (P<0.05).With correlation analysis,it showed that the percentage of ghrelin-positive cells in liver cirrhotic patients had negative correlation with appetite(r=-0.432,P<0.05),TSF(r=-0.525,P<0.05),ISI(r=-0.509,P<0.05) and positive correlation with serum glucose(r=0.449,P<0.05).The overexpression of ghrelin in liver cirrhotic patients may contribute to the adaptations of negative energy balance.It might contribute to insulin resistance in patients with hepatic cirrhosis.