Serum ghrelin, adipokine and insulin levels in children with acute hepatitis.

Objectives: Recent reports suggest that adipokines are potent modulators of inflammation. We tested the hypothesis that the decreased food intake and the acute liver disease might be associated with changes of serum ghrelin, adipokines and insulin levels.

Methods: Fasting ghrelin, adiponectin, leptin, resistin and insulin were measured in 25 children suffering from acute viral hepatitis, caused by either hepatitis A or Epstein-Barr viruses. The age of the patients ranged from 2.2 to 17.2 years (mean: 10.4 years); 10 male and 15 female. Samples for hormones and liver function tests were drawn at 08 : 00 to 09 : 00 h after an overnight fast. The first samples were collected in the morning after the day of admission, the second samples after 2 months of recovery.

Results: Ghrelin and adiponectin levels were significantly higher during hepatitis than after recovery (831.4+/-276.44 vs. 736.21+/-274.91 pg/ml, P<0.0001; and 22.91+/-12.93 vs. 15.16+/-8.81 microg/ml, P<0.001, respectively). Adiponectin levels correlated significantly with age-specific and sex-specific body mass index-matched percentile values as well (P=0.0062). Linear regression analysis confirmed that there was a significant association of changes in serum ghrelin and resistin levels and the severity of hepatitis (P=0.005; P<0.05). We could verify a marginal relationship of the changes of serum leptin and the severity of the disease (P=0.0646).

Conclusion: This study confirms that there are significant changes in serum levels of ghrelin, and adipokines in disease-associated malnutrition and acute hepatitis.