Relationship between ghrelin, Helicobacter pylori and gastric mucosal atrophy in hemodialysis patients

Table 1 The criteria of the classification of Helicobacter pylori infection

	(1) Anti-H. pylori IgG	Endoscopic gastric mucosal atrophy
	(2) RUT
	(3) Culture test
Present infection	Positive at least one detection systems
Past infection	Negative with all of three detection systems	Positive for atrophy
Non-infection	Negative with all of three detection systems	No atrophy

H. pylori: Helicobacter pylori; RUT: Rapid urease test.

Table 2 Characteristics of patients who received hemodialysis

Age (yr)	68.8 ± 11.2
Male/female (n/n)	68/40
Duration of hemodialysis (yr)	8.7 ± 8.6
Body weight (kg)	51.4 ± 11.4
Body mass index (kg/m2)	20.2 ± 3.5
Albumin (g/dL)	3.4 ± 0.4
Total cholesterol (mg/dL)	159.5 ± 36.4
Cholinesterase (U/L)	230.3 ± 87.2
Infection of H. pylori: non/past/present	29/30/49
Acyl-ghrelin (fmol/mL)	25.9 ± 19.8
Desacyl-ghrelin (fmol/mL)	256.2 ± 158.4
Pepsinogen I (ng/mL)	349.9 ± 294.5
Pepsinogen II (ng/mL)	43.5 ± 32.3
Pepsinogen I/II ratio	8.3 ± 4.7

Values are presented as mean ± standard deviation. Non, negative with all three detection systems (anti-H. pylori IgG serological test, rapid urease test and culture test) and endoscopic gastric mucosal atrophy; past, negative with all detection systems for H. pylori and positive for endoscopic gastric mucosal atrophy; present, positive results were observed with at least one of the detection systems. H. pylori: Helicobacter pylori.

Table 3 Relationship between Helicobacter pylori status and plasma ghrelin level

H. pylori status	Non-infection	Past infection	Present infection	P value
Number	29	30	49
Male/female (n/n)	19/10	22/8	27/22	0.275
Age (yr)	67.9 ± 10.7	71.7 ± 11.3	67.6 ± 11.3	0.119
Body weight (kg)	51.2 ± 12.1	49.0 ± 8.3	51.9 ± 12.4	0.468
BMI (kg/m2)	19.9 ± 3.4	19.3 ± 2.3	21.0 ± 4.0	0.160
Albumin (g/dL)	3.5 ± 0.3	3.5 ± 0.4	3.3 ± 0.4	0.156
Total cholesterol (mg/dL)	167.5 ± 36.1	149.5 ± 29.0	161.5 ± 44.2	0.175
Cholinesterase (U/L)	247.0 ± 109.3	228.5 ± 64.3	207.5 ± 75.3	0.310
Acyl-ghrelin (fmol/mL)	39.4 ± 23.0	23.4 ± 19.9a	19.5 ± 14.0a	< 0.001
Desacyl-ghrelin (fmol/mL)	353.2 ± 190.2	234.9 ± 137.5a	211.8 ± 124.2a	0.001
Pepsinogen I (ng/mL)	551.8 ± 319.2	286.5 ± 268.2a	269.3 ± 238.0a	< 0.001
Pepsinogen II (ng/mL)	46.4 ± 24.5	28.5 ± 17.4a	51.0 ± 39.9	0.002
Pepsinogen I/II	12.2 ± 4.5	9.3 ± 4.1a	5.3 ± 2.9a	< 0.001

^aP < 0.05 vs the non-infection group. Values are presented as mean ± SD. BMI: Body mass index; H. pylori: Helicobacter pylori.

Table 4 Relationship between endoscopic gastric mucosal atrophy and plasma ghrelin level

Mucosal atrophy	Non-atrophy	Mild atrophy	Moderate atrophy	Severe atrophy	P value
Number	32	15	29	32
Male/female (n/n)	19/13	10/5	19/10	20/12	0.969
Age (yr)	67.5 ± 11.8	64.5 ± 12.3	71.9 ± 10.9	69.3 ± 10.0	0.293
Body weight (kg)	50.7 ± 12.0	53.6 ± 10.5	50.6 ± 11.4	51.5 ± 11.4	0.708
BMI (kg/m2)	19.9 ± 3.4	20.3 ± 2.8	20.1 ± 3.6	20.6 ± 3.9	0.896
Albumin (g/dL)	3.5 ± 0.3	3.5 ± 0.3	3.3 ± 0.4	3.4 ± 0.5	0.351
Total cholesterol (mg/dL)	166.4 ± 34.8	159.9 ± 34.9	153.6 ± 37.5	151.4 ± 40.4	0.510
Cholinesterase (U/L)	246.0 ± 104.3	250.5 ± 77.7	201.9 ± 59.3	218.6 ± 77.6	0.283
Acyl-ghrelin (fmol/mL)	39.4 ± 22.2	24.5 ± 23.1a	20.2 ± 14.9a	18.3 ± 11.8a	< 0.001
Desacyl-ghrelin (fmol/mL)	345.7 ± 183.7	276.1 ± 169.4	212.6 ± 129.4a	196.8 ± 104.4a	< 0.001
Pepsinogen I (ng/mL)	525.9 ± 316.6	461.9 ± 330.3	284.2 ± 207.3a	181.0 ± 198.8a	< 0.001
Pepsinogen II (ng/mL)	45.9 ± 23.8	49.3 ± 32.0	45.8 ± 40.8	36.3 ± 31.6	0.120
Pepsinogen I/II	11.6 ± 4.7	10.0 ± 4.6	6.9 ± 3.4a	5.3 ± 3.3a	< 0.001

^aP < 0.05 vs the non-atrophy group. Values are presented as mean ± SD. BMI: Body mass index.