An investigation into the relationship of total ghrelin with nutritional and inflammatory status and quality of life of patients on maintenance hemodialysis

Abstract

This study was aimed to assess the serum total ghrelin levels and its possible relationship with appetite inflammation and nutritional status in patients on MHD The study included 90 patients on MHD for six months and above and 70 healthy volunteers as control Demographics were obtained from the study population and dialysis related data were collected for cases Anthropometric biochemical parameters serum total ghrelin and inflammatory markers Tumour necrosis factor alpha and high sensitive C reactive protein were assessed for cases and control The case population was further assessed for appetite using five questions of Appetite and Diet Assessment Tool nutritional status using Subjective Global Assessment Dialysis Malnutrition Score and Health related Quality of Life using Health survey for dialysis patients Short Form 36 questionnaire Ghrelin TNF alpha hs CRP were significantly elevated in cases than the control anthropometric and biochemical parameters were significantly decreased in hemodialysis patients Of 90 cases 14 percent were well nourished 31 percent were mild to moderately malnourished and 54 percent were moderate to severely malnourished SGA DMS had negative correlation with anthropometry indicating that higher the scores poorer was the nutritional status and lower was the anthropometry Appetite was very good for 14 percent good and fair for 47 percent poor and very poor for 37 percent patients There was a statistically significant difference in appetite with respect to nutritional status Ghrelin had a positive correlation with TNF alpha hs CRP and SGA DMS Similarly TNF alpha and hs CRP also had a positive correlation with SGADMS Patients with poor and very poor appetite had a highly significant elevated levels of Ghrelin TNF alpha and hs CRP The mean quality of life scores were found to be lower for those with higher SGADMS and ADAT scores indicating that poorer the appetite and the nutritional status significantly poorer was the QoL Similarly ghrelin TNF alpha and hs CRP also had a negative