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Published ahead of print on July 21, 2004, doi:10.1164/rccm.200310-1404OC

Am. J. Respir. Crit. Care Med., Volume 170, Number 8, October 2004, 879-882

A more recent version of this article appeared on October 15, 2004
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Submitted on October 14, 2003
Accepted on July 20, 2004

Elevated Plasma Ghrelin Level in Underweight Patients with Chronic Obstructive Pulmonary Disease

Takefumi Itoh1, Noritoshi Nagaya2*, Masanori Yoshikawa3, Atsuhiko Fukuoka3, Hideaki Takenaka3, Yoshito Shimizu4, Yoshinori Haruta5, Hideo Oya6, Masakazu Yamagishi6, Hiroshi Hosoda7, Kenji Kangawa7, and Hiroshi Kimura3

1 Department of Internal Medicine, National Cardiovascular Center, Suita, Osaka, Japan; Second Department of Internal Medicine, Nara Medical University, Kashihara, Nara, Japan, 2 Department of Internal Medicine, National Cardiovascular Center, Suita, Osaka, Japan; Department of Regenerative Medicine and Tissue Engineering, National Cardiovascular Center Research Institute, Suita, Osaka, Japan, 3 Second Department of Internal Medicine, Nara Medical University, Kashihara, Nara, Japan, 4 Department of Regenerative Medicine and Tissue Engineering, National Cardiovascular Center Research Institute, Suita, Osaka, Japan, 5 Department of Respiratory Medicine, Chugoku Rousai Hospital, Kure, Hiroshima, Japan, 6 Department of Internal Medicine, National Cardiovascular Center, Suita, Osaka, Japan, 7 Department of Biochemistry, National Cardiovascular Center Research Institute, Suita, Osaka, Japan

* To whom correspondence should be addressed. E-mail: nagayann{at}hsp.ncvc.go.jp.

Ghrelin, a novel growth hormone-releasing peptide, has been shown to cause a positive energy balance by reducing fat utilization and stimulating food intake. This study investigated whether plasma ghrelin is associated with clinical parameters in patients with chronic obstructive pulmonary disease. Plasma ghrelin was measured in 50 patients and 13 control subjects, together with anabolic and catabolic factors. Patients were divided into two groups based on body mass index; underweight patients (n = 26) or normal weight patients (n = 24). Plasma ghrelin was significantly higher in underweight patients than in normal weight patients and healthy controls. Circulating tumor necrosis factor-{alpha}, interleukin-6, and norepinephrine were significantly higher in underweight patients than in normal weight patients. Plasma ghrelin correlated negatively with body mass index and correlated positively with catabolic factors such as tumor necrosis factor-{alpha} and norepinephrine. In addition, plasma ghrelin correlated positively with percent predicted residual volume and residual volume/total lung capacity ratio. In conclusion, plasma ghrelin was elevated in underweight patients with chronic obstructive pulmonary disease, and the level was associated with a cachectic state and abnormality of pulmonary function.
Key words: pulmonary disease, chronic obstructive, cachexia, ghrelin, hormones




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