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.