血清Ghrelin和瘦素水平与幽门螺杆菌感染的关系研究

Relation of Helicobacter Pylori Infection with Serum Ghrelin and Leptin Levels

目的探讨血清Ghrelin和瘦素水平与幽门螺杆菌(Hp)感染的关系,进一步明确其临床意义。方法选取2009年4—7月于北京大学第三医院进行胃镜检查的患者116例,于胃镜检查前抽血检测血清Ghrelin和瘦素水平,同时检测血清Hp抗体。所有患者进行胃镜检查时于胃窦和胃体至少分别钳取一块组织进行Warthin-Starry染色,判定Hp感染情况。血清Ghrelin、瘦素和Hp抗体检测采用ELISA法。结果 Hp阳性患者血清Ghrelin水平低于Hp阴性患者(291.03 pg/ml vs.374.77 pg/ml),Hp阳性患者血清瘦素水平亦低于Hp阴性患者(4.34 ng/ml vs.4.37 ng/ml),但差异均无统计学意义(P值分别为0.288、0.550)。男性患者血清Ghrelin水平低于女性患者(232.28 pg/mlvs.403.09 pg/ml),差异有统计学意义(P=0.000);男性患者血清瘦素水平亦低于女性患者(4.24 ng/ml vs.4.46 ng/ml),但差异无统计学意义(P=0.671)。男性患者Hp阳性组与Hp阴性组血清Ghrelin水平间差异无统计学意义(243.87 pg/ml vs.205.67 pg/ml,P=0.950),血清瘦素水平间差异亦无统计学意义(4.16 ng/ml vs.4.42 ng/ml,P=0.297)。女性患者Hp阳性组与Hp阴性组血清Ghrelin水平间差异无统计学意义(342.12 pg/ml vs.494.54 pg/ml,P=0.330),血清瘦素水平间差异亦无统计学意义(4.54 ng/ml vs.4.34 ng/ml,P=0.856)。体质指数(BMI)<24.0 kg/m2组与BMI≥24.0 kg/m2组血清Ghrelin水平间差异有统计学意义(362.28 pg/ml vs.238.40 pg/ml,P=0.003),血清瘦素水平间差异亦有统计学意义(3.83 ng/ml vs.5.39 ng/ml,P=0.000)。BMI<24.0 kg/m2时,Hp阳性组与Hp阴性组血清Ghrelin水平间差异无统计学意义(303.85 pg/ml vs.483.81 pg/ml,P=0.107),血清瘦素水平间差异亦无统计学意义(3.79 ng/ml vs.3.91 ng/ml,P=0.387)。BMI≥24.0 kg/m2时,Hp阳性组与Hp阴性组血清Ghrelin水平间差异无统计学意义(262.06 pg/ml vs.204.39 pg/ml,P=0.621),血清瘦素水平间差异亦无统计学意义(5.59 ng/mlvs.5.10 ng/ml,P=0.388)。结论 Hp感染与否对血清Ghrelin及瘦素水平没有影响,性别对血清Ghrelin水平可能有影响,BMI对血清Ghrelin及瘦素水平可能有影响。

Objective To investigate the relationship of serum Ghrelin and leptin levels with Helicobacter pylori（Hp） infection,and further identify its clinical significance.Methods Totally 116 patients who underwent gastroscopy from April to July 2009 were recruited.Blood serum Ghrelin and leptin levels and serum immunoglobulin G antibodies against Hp were assessed by ELISA method.All patients underwent gastroscopy with biopsies from gastric antrum and gastric body in order to judge Hp infection status with Warthin-Starry staining.Results The serum Ghrelin level and leptin level of Hp positivity patients were respectively lower than those of Hp negativity patients（291.03 pg/ml vs 374.77 pg/ml and 4.34 ng/ml vs 4.37 ng/ml,respectively）,but with no statistically significant difference（P=0.288,0.550）.The Ghrelin level of male patients was significantly lower than that of female patients（232.28 pg/ml vs.403.09 pg/ml）（P=0.000）;and the leptin level of male patients was also lower than that of female patients（4.24 ng/ml vs.4.46 ng/ml）,but with no statistical significance（P=0.671）.No statistically significant difference was found in Ghrelin level between male patients with Hp positivity and with Hp negativity（243.87 pg/ml vs.205.67 pg/ml,P=0.950）,so was in leptin level（4.16 ng/ml vs.4.42 ng/ml,P=0.297）.No statistically significant difference was found in both Ghrelin level and leptin level between female patients with Hp positivity and with Hp negativity（342.12 pg/ml vs.494.54 pg/ml,P=0.330;4.54 ng/ml vs.4.34 ng/ml,P=0.856,respectively）.There were significant difference in Ghrelin and leptin levels between patients whose body mass index（BMI）24.0 kg/m2 and BMI≥24.0 kg/m2（362.28 pg/ml vs.238.40 pg/ml,P=0.003;3.83 ng/ml vs.5.39 ng/ml,P=0.000,respectively）.For those whose BMI24.0 kg/m2,there was no significant difference in Ghrelin and leptin levels between patients with Hp positivity and with Hp negativity（303.85 pg/ml vs.483.81 pg/ml,P=0.107;3.79 ng/ml vs.3.91 ng/ml,P=0.387,respectively）;and for those whose BMI≥24.0 kg/m2,there was also no significant difference in Ghrelin and leptin levels between patients with Hp positivity and with Hp negativity（262.06 pg/ml vs.204.39 pg/ml,P=0.621;5.59 ng/ml vs.5.10 ng/ml,P=0.388）.Conclusion Serum Ghrelin and leptin levels were not associated with Hp infection.Serum Ghrelin levels may be associated with gender,also serum Ghrelin and leptin levels may be associated with BMI.