CHANGES IN SERUM GHRELIN AND ITS RELATIONSHIP WITH OF BODY MASS INDEX IN PATIENTS WITH GASTROESOPHAGEAL REFLUX DISEASE AND SPONDYLOARTHRITIS

Abstract

The aim: To determine the features of changes in serum ghrelin levels and its relationship with the body mass index in patients with GERD and spondyloarthritis (SpA) with lesions of the cervical and thoracic spine. Materials and methods: The examined patients included 80 patients with SpA with cervical and thoracic spine lesions in combination with GERD. The examined patients with SpA with predominant cervical and thoracic spine lesions were divided into two groups depending on the clinical course of GERD, namely: group I included 33 (41.2%) patients with typical esophageal manifestations of GERD (13 males (39.4%), 20 females (60.6%)), and group II consisted of 47 (58.8%) patients with atypical extraesophageal manifestations of GERD (among them were 17 (36.2%) males and 30 (63.2%) females). Results: All patients were tested for serum ghrelin by enzyme-linked immunosorbent assay. Analysis of clinical manifestations of atypical GERD (group II patients) revealed that most often patients with SpA of the cervical and thoracic spine were diagnosed with dental and otolaryngological masks of reflux disease (40.4 % and 25.5 % of patients, respectively). Maximum serum ghrelin levels were detected in patients with SpA with cardiac GERD (355.02 ± 4.75 ng/ml), while minimum values were found in patients with dental signs of reflux disease (298.17 ± 5.16 ng/ml – p <0.05). Conclusions: 1. In patients with SpA with cervical and thoracic spine lesions, GERD often has atypical symptoms (mostly dental and otolaryngological forms in 40.4% and 25.5% of patients). 2. In patients with SpA with esophageal clinical signs of GERD, normal weight or underweight is more common, while in patients with extraesophageal forms of GERD overweight or obesity of varying severity prevails. 3. In patients with SpA and GERD, an increase in serum ghrelin levels was found in patients with cardiac manifestations of reflux disease (355.02 ± 4.75 ng/ml). 4. The relationship between BMI changes in patients with SpA and GERD and increased serum ghrelin levels was found, namely: in group II patients with overweight and obesity a direct correlation was found, and in group I patients with underweight an inverse correlation was fund.