Study of the Changes in Serum Ghrelin Level in Children with Chronic Liver Diseases and Correlation with the Nutritional Status

Abstract

hronic liver diseases are the continuity of clinical or biochemical evidence of hepatic dysfunction for longer than six months. Chronic liver diseases in children are relatively common disorders with minimal symptoms but long-term risk of significant morbidity and mortality particularly in developing countries. Malnutrition is frequently seen in children with chronic liver diseases and all children with chronic liver diseases must undergo a periodic nutritional assessment as they are at a high risk for malnutrition. The aim of the present study is to assess the serum levels of ghrelin in children with chronic liver diseases and to clarify their correlation with different nutritional parameters. This study was conducted on 60 children, 40 children with chronic liver diseases (patients group) of different etiologies recruited from Hepatology Clinic, Ain Shams University during the period from September 2012 to May 2013 and 20 healthy children (controls group) who were age and sex matched with the patients group. In all children serum ghrelin level was measured by ELISA with correlation with different nutritional parameters, and for patients detailed history, clinical examination and laboratory investigations (CBC, liver enzymes, serum bilirubin, serum albumin and prothombin time) were done. Our study found a significant difference in the BMI percentiles between children with chronic liver diseases and healthy controls, and the serum ghrelin level in children with chronic liver diseases was significantly higher than controls, and also higher in patients had ascites than patients had no ascites. Serum ghrelin level showed a significant correlation with liver functions and haemoglobin level where it showed positive correlation with ALT, prothrombin time and total bilirubin levels and showed negative correlation with serum albumin and haemoglobin levels. Serum ghrelin level showed also a significant negative correlation with the studied anthrop-ometric parameter (BMI).