The article describes and analyzes the level of ghrelin in patients with chronic pancreatitis and atherosclerosis. The purpose of the work was to investigate the changes in the level of ghrelin in patients with chronic pancreatitis and atherosclerosis, depending on the lipidogram and the degree of external secretion of pancreatic insufficiency. Material and methods. For the diagnosis of chronic pancreatitis, we analyzed complaints, anamnesis, laboratory-instrumental methods of research in accordance with the Marseilles-Roman criteria (1989), supplemented by Ya. S. Сimmermann (1995), and refinements of ICD-10 on the basis of the ballroom system M-ANNHEIM. All patients also had an ultrasound examination of the hepatotoxic biliary system. We conducted mixed triglyceride 13C breath test (13C-MTBT) and amylase 13C-breath test (13C-ABT) for detection of exocrine pancreatic insufficiency. Atherosclerotic changes were diagnosed by measuring the thickness of the intima-media layer in the carotid artery and changes in the lipid profile of the blood (by determining the total blood plasma cholesterol, triglycerides, high density lipoprotein cholesterol, low density lipoprotein and atherogenicity). Serum ghrelin levels were determined using an enzyme-linked immunosorbent assay according to the implementation method. The human immunodeficiency kit RayBiotech Human/Mouse/Rat Ghrelin Enzyme Immunoassay Kit was used for the study. The exocrine pancreatic insufficiency was observed in all patients by using the triglyceride respiratory test. Results and discussion. The level of ghrelin in serum in the control group was within 108.167±4.73 ng/ml. These figures were taken as normal values of the ghrelin level. In contrast, in Group I, the concentration of ghrelin in the blood serum was 173.154±7.76 ng/ml, while in Group II its level was 285.929±9.971 ng/ml. According to the results of the study, a high concentration and a statistically significant difference in serum ghrelin levels in patients with chronic pancreatitis and atherosclerosis were observed compared to the control group and those with chronic pancreatitis without atherosclerotic changes. Conclusions. Based on the results of mixed triglyceride 13C breath test and amylase 13C-breath test in patients with less severe exocrine pancreatic insufficiency disorders and without atherosclerosis, the level of ghrelin was statistically significant and higher compared to the control group. This indicator was significantly higher in patients with severe exocrine pancreatic insufficiency with atherosclerosis in comparison with the control group and the group of patients with chronic pancreatitis with less pronounced exocrine pancreatic insufficiency and without atherosclerosis.
Keywords: Ghrelin, 13C-mixed triglyceride breath test, 13C-amylase breath test, chronic pancreatitis, atherosclerosis
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