Circulating ghrelin level is increased in coeliac disease as in functional dyspepsia and reverts to normal during gluten-free diet

Background: It is controversial whether serum ghrelin concentration is altered in coeliac disease and whether this alteration is related to nutritional impairment or to inflammatory changes of duodenal mucosa. Aim: To investigate clinical and histopathological variables affecting circulating ghrelin in coeliac patients by comparison with dyspeptic patients and with healthy controls. Methods: We measured serum ghrelin and obtained gastric and duodenal biopsies in 44 coeliac patients before and after 1-year gluten-free diet, in 39 dyspeptic patients and 53 healthy controls. Results: Serum ghrelin concentration was significantly higher in coeliac (531 ± 29 pg/mL, P < 0.05) and in dyspeptic patients (526 ± 14 pg/mL, P < 0.01) than in healthy controls (451 ± 8 pg/mL), and body mass index was significantly lower in coeliac (20 ± 1) and in dyspeptic patients (20 ± 1) than in healthy controls (22 ± 1, P < 0.05). In coeliac patients serum ghrelin concentration was not related to the severity of duodenal lesions. Serum ghrelin reverted to normal (399 ± 30 pg/mL) and body mass index increased significantly (0.6 ± 0.1 kg/m2 increase, P < 0.05) during gluten-free diet despite persistent duodenal lymphocytic infiltration. Conclusions: Ghrelin concentration is increased and body mass index is decreased in coeliac and in dyspeptic patients irrespective of presence and severity of duodenal inflammation. Nutritional impairment is a key factor in elevating plasma ghrelin levels in coeliac disease. © 2006 Blackwell Publishing Ltd.