Characteristics of studies evaluating ghrelin or obestatin levels in IBD patients.
| Author . | Year . | Design . | Location . | Specimen . | Population . | IBD type(s) . | Sample size . | Age (y) . | % Male . | BMI (kg/m2) . | Mean disease duration (y) . | Main findings . |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Alexandridis et al14 | 2009 | Cross-sectional | Greece | Serum | IBD patients | UC CD | UC: 22 CD: 31 | UC: 45.4 ± 14.8 CD: 40.3 ± 12.6 | NR | UC: 25.1 ± 3.3 CD: 23.4 ± 3.3 | UC: 10.6 ± 9.3 CD: 5.3 ± 5.2 | Significantly higher ghrelin values and significantly lower obestatin/ghrelin were found in active IBD compared with patients in remission. |
| Ates et al8 | 2008 | Prospective | Turkey | Serum | IBD patients and age-, sex, and BMI-matched HC subjects | UC CD | UC: 34 CD: 25 HC: 30 | UC: 38.3 ± 12.6 CD: 39.6 ± 12.4 HC: 36.1 ± 12.8 | UC: 58.8 CD: 56.0 HC: 60.0 | UC: 23.6 ± 3.9 CD: 23.3 ± 4.5 HC: 25.8 ± 3.2 | UC: 6.5 ± 6.3 CD: 6.4 ± 6.3 | No difference was found between UC, CD, and control subjects. However, ghrelin levels were significantly higher in active disease compared with remission in both UC and CD patients (P < .001). |
| Cekic et al26 | 2014 | Cross-sectional | Turkey | Serum | IBD patients | UC CD | UC: 52 CD: 33 | IBD: 42.8 ± 10.2 | IBD: 50.6 | NR | NR | Ghrelin levels were significantly higher in active IBD compared with remission and in subgroups of IBD. The AUC for establishing disease severity using ghrelin was 0.934 (95% CI, 0.884-0.984). |
| Ghomraoui et al49 | 2017 | Case-control | Saudi Arabia | Plasma | IBD patients and HC subjects | UC CD | UC: 11 CD: 20 HC: 41 | IBD: 32.3 ± 11.8 HC: 29.2 ± 10.2 | IBD: 32.3 HC: 41.5 | IBD: 24 ± 8.5 HC: 28.1 ± 6.9 | NR | Ghrelin levels were significantly higher in active disease IBD compared with remission (P = .02). |
| Jung et al15 | 2015 | Cross-sectional | Korea | Serum | UC patients | UC | UC: 21 | UC: 46.8 ± 14.2 | UC: 61.9 | UC: 21.8 ± 3.6 | UC: 3.0 ± 2.7 | Ghrelin levels were significantly higher in active disease compared with remission of the disease (P = .001), while obestatin was comparable between groups (P = .325). Finally, the obestatin/ghrelin ratio was significantly higher in remission of disease compared with active UC (P = .001). |
| Karmiris et al7 | 2006 | Prospective | Greece | Serum | IBD patients and age- and sex-matched HC subjects | UC CD | UC: 46 CD: 54 HC: 60 | UC: 46 CD: 37 HC: 36 | UC: 58.0 CD: 42.0 | UC: 25.5 CD: 24.0 | UC: 9.5 CD: 5.3 | Serum ghrelin levels were significantly higher in IBD patients compared with HC subjects (P < .0001). |
| Kim et al16 | 2017 | Retrospective | Korea | Serum | CD patients with more than 2 y disease duration | CD | CD: 153 | CD: 36.1 ± 10.0 | CD: 81.0 | CD: 20.6 ± 1.0 | CD: 10.2 ± 4.0 | Serum ghrelin levels were not different between CD patients with remission and active disease (P = .574). |
| Koutroubakis et al13 | 2011 | Prospective | Greece | Serum | IBD patients | UC CD | UC: 54 CD: 64 | UC: 42 CD: 36 | UC: 44.4 CD: 43.8 | NR | UC: 8.3 CD: 9.8 | Ghrelin levels were significantly higher in IBD patients with osteoporosis compared with IBD patients with osteopenia and normal IBD (P = .038). |
| Lönnkvist et al12 | 2011 | Prospective | Sweden | Plasma | CD patients and HC subjects | CD | CD: 22 HC: 10 | UC: 38 HC: NR | NR | NR | UC: 12.3 | Plasma ghrelin reduced after infliximab at initial and 6-mo follow-up (P < .05 and P = .06, respectively), while it was comparable to control subjects at visits (P > .05). |
| Lv et al27 | 2023 | Cross-sectional | China | Serum | UC patients and HC subjects | UC | UC: 90 HC: 40 | UC: 39.7 ± 10.6 HC: 39.8 ± 10.5 | UC: 56.7 HC: 55.0 | NR | NR | Ghrelin levels were significantly lower in UC patients (P < .001), and active disease patients had lower ghrelin levels compared with patients in the remission group and healthy control subjects (P < .001). Ghrelin acted as an acceptable marker for diagnosing active UC (AUC, 0.788; 95% CI, 0.690-0.894). |
| Moran et al28 | 2013 | Cross-sectional | United Kingdom | Plasma | Active CD patients and HC subjects | CD | CD: 17 CDRx: 6 HC: 13 | CD: 41.4 ± 4.8 CDRx: 56.2 ± 6.3 HC: 36.9 ± 3.0 | CD: 35.3 CDRx: 50.0 HC: 53.8 | HC: 25.3 ± 1.4 | NR | No change was found between CD patients and the HC group in the postprandial response of ghrelin (P = .1015). |
| Nishi et al10 | 2005 | Cross-sectional | Japan | Plasma | CD outpatients and age- and sex-matched HC subjects | CD | CD: 28 HC: 46 | CD: 32 HC: NR | CD: 57.1 HC: NR | CD: 20.5 ± 0.4 HC: 21.0 ± 0.7 | NR | Although no difference in ghrelin levels was found between CD patients and Helicobacter pylori–negative HC subjects, ghrelin was significantly lower in H. pylori–positive HC subjects compared with CD patients (P < .01) and negative HC subjects (P < .05). |
| Ortega Moreno et al29 | 2020 | Cross-sectional | Spain | Serum | CD patients and HC subjects | CD | CD: 40 HC: 36 | CD: 45.6 ± 12.6 HC: 51.4 ± 15.1 | CD: 47.5 HC: 44.4 | CD: 25.1 ± 4.1 HC: 24.4 ± 3.9 | NR | No significant difference was found between CD patients and HC subjects in ghrelin concentration (P = .07). |
| Peracchi et al9 | 2006 | Cross-sectional | Italy | Serum | IBD patients and HC subjects | UC CD | UC: 53 CD: 43 HC: 40 | IBD: 48.4 ± 16 HC: 42 ± 14 | IBD: 60.4 HC: 50.0 | IBD: 23.2 ± 3.2 HC: 22.1 ± 2.5 | NR | Ghrelin levels were significantly higher in active IBD compared with inactive IBD and HC subjects (P < .001 for both comparisons), while no difference was found between UC and CD. |
| Piquer et al30 | 2006 | Cross-sectional | France | Plasma | IBD patients and HC subjects | UC CD | UC: 3 CD: 18 HC: 28 | IBD: 29.5 ± 9.5 HC: 30.9 ± 9.2 | IBD: 52.4 HC: NR | IBD: 22.5 ± 5.8 HC: 21.6 ± 2.0 | NR | No significant difference was found in ghrelin levels between active IBD, quiescent IBD, and HC subjects (P > .05). |
| Sales et al31 | 2019 | Prospective | Brazil | Serum | IBD patients | UC CD | UC: 13 CD: 14 | IBD: 47.0 ± 14.5 | IBD: 40.7 | IBD: 25.4 ± 4.7 | NR | No significant difference was found in ghrelin levels between IBD patients with and without gastroduodenal symptoms (P > .05). |
| Sung et al35 | 2008 | Prospective | United Kingdom | Plasma | CD patients | CD | CD: 15 | CD: 31.5 ± 9.8 | CD: 66.7 | CD: 22.9 ± 3.4 | NR | About a 25% increase in total ghrelin levels was found after infliximab while des-acyl and acylated ghrelin levels remained unchanged. |
| Trejo-Vazquez et al33 | 2018 | Case-control | Mexico | Serum | IBD patients and HC subjects | UC CD | UC: 23 CD: 11 HC: 19 | IBD: 54.8 ± 15.1 HC: 53.2 ± 9.6 | IBD: 41.2 HC: 15.8 | IBD: 27.6 ± 5.9 HC: 28.4 ± 6.5 | NR | No significant difference was found in ghrelin levels between patients with CD, patients with UC, and HC subjects (P = .745). |
| Zhang et al34 | 2012 | Cross-sectional | China | Serum | Active UC patients and HC subjects | UC | UC: 54 HC: 25 | NR | NR | NR | NR | Serum ghrelin levels were significantly higher in patients with active UC compared with HC subjects (P = .041). |
| Author . | Year . | Design . | Location . | Specimen . | Population . | IBD type(s) . | Sample size . | Age (y) . | % Male . | BMI (kg/m2) . | Mean disease duration (y) . | Main findings . |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Alexandridis et al14 | 2009 | Cross-sectional | Greece | Serum | IBD patients | UC CD | UC: 22 CD: 31 | UC: 45.4 ± 14.8 CD: 40.3 ± 12.6 | NR | UC: 25.1 ± 3.3 CD: 23.4 ± 3.3 | UC: 10.6 ± 9.3 CD: 5.3 ± 5.2 | Significantly higher ghrelin values and significantly lower obestatin/ghrelin were found in active IBD compared with patients in remission. |
| Ates et al8 | 2008 | Prospective | Turkey | Serum | IBD patients and age-, sex, and BMI-matched HC subjects | UC CD | UC: 34 CD: 25 HC: 30 | UC: 38.3 ± 12.6 CD: 39.6 ± 12.4 HC: 36.1 ± 12.8 | UC: 58.8 CD: 56.0 HC: 60.0 | UC: 23.6 ± 3.9 CD: 23.3 ± 4.5 HC: 25.8 ± 3.2 | UC: 6.5 ± 6.3 CD: 6.4 ± 6.3 | No difference was found between UC, CD, and control subjects. However, ghrelin levels were significantly higher in active disease compared with remission in both UC and CD patients (P < .001). |
| Cekic et al26 | 2014 | Cross-sectional | Turkey | Serum | IBD patients | UC CD | UC: 52 CD: 33 | IBD: 42.8 ± 10.2 | IBD: 50.6 | NR | NR | Ghrelin levels were significantly higher in active IBD compared with remission and in subgroups of IBD. The AUC for establishing disease severity using ghrelin was 0.934 (95% CI, 0.884-0.984). |
| Ghomraoui et al49 | 2017 | Case-control | Saudi Arabia | Plasma | IBD patients and HC subjects | UC CD | UC: 11 CD: 20 HC: 41 | IBD: 32.3 ± 11.8 HC: 29.2 ± 10.2 | IBD: 32.3 HC: 41.5 | IBD: 24 ± 8.5 HC: 28.1 ± 6.9 | NR | Ghrelin levels were significantly higher in active disease IBD compared with remission (P = .02). |
| Jung et al15 | 2015 | Cross-sectional | Korea | Serum | UC patients | UC | UC: 21 | UC: 46.8 ± 14.2 | UC: 61.9 | UC: 21.8 ± 3.6 | UC: 3.0 ± 2.7 | Ghrelin levels were significantly higher in active disease compared with remission of the disease (P = .001), while obestatin was comparable between groups (P = .325). Finally, the obestatin/ghrelin ratio was significantly higher in remission of disease compared with active UC (P = .001). |
| Karmiris et al7 | 2006 | Prospective | Greece | Serum | IBD patients and age- and sex-matched HC subjects | UC CD | UC: 46 CD: 54 HC: 60 | UC: 46 CD: 37 HC: 36 | UC: 58.0 CD: 42.0 | UC: 25.5 CD: 24.0 | UC: 9.5 CD: 5.3 | Serum ghrelin levels were significantly higher in IBD patients compared with HC subjects (P < .0001). |
| Kim et al16 | 2017 | Retrospective | Korea | Serum | CD patients with more than 2 y disease duration | CD | CD: 153 | CD: 36.1 ± 10.0 | CD: 81.0 | CD: 20.6 ± 1.0 | CD: 10.2 ± 4.0 | Serum ghrelin levels were not different between CD patients with remission and active disease (P = .574). |
| Koutroubakis et al13 | 2011 | Prospective | Greece | Serum | IBD patients | UC CD | UC: 54 CD: 64 | UC: 42 CD: 36 | UC: 44.4 CD: 43.8 | NR | UC: 8.3 CD: 9.8 | Ghrelin levels were significantly higher in IBD patients with osteoporosis compared with IBD patients with osteopenia and normal IBD (P = .038). |
| Lönnkvist et al12 | 2011 | Prospective | Sweden | Plasma | CD patients and HC subjects | CD | CD: 22 HC: 10 | UC: 38 HC: NR | NR | NR | UC: 12.3 | Plasma ghrelin reduced after infliximab at initial and 6-mo follow-up (P < .05 and P = .06, respectively), while it was comparable to control subjects at visits (P > .05). |
| Lv et al27 | 2023 | Cross-sectional | China | Serum | UC patients and HC subjects | UC | UC: 90 HC: 40 | UC: 39.7 ± 10.6 HC: 39.8 ± 10.5 | UC: 56.7 HC: 55.0 | NR | NR | Ghrelin levels were significantly lower in UC patients (P < .001), and active disease patients had lower ghrelin levels compared with patients in the remission group and healthy control subjects (P < .001). Ghrelin acted as an acceptable marker for diagnosing active UC (AUC, 0.788; 95% CI, 0.690-0.894). |
| Moran et al28 | 2013 | Cross-sectional | United Kingdom | Plasma | Active CD patients and HC subjects | CD | CD: 17 CDRx: 6 HC: 13 | CD: 41.4 ± 4.8 CDRx: 56.2 ± 6.3 HC: 36.9 ± 3.0 | CD: 35.3 CDRx: 50.0 HC: 53.8 | HC: 25.3 ± 1.4 | NR | No change was found between CD patients and the HC group in the postprandial response of ghrelin (P = .1015). |
| Nishi et al10 | 2005 | Cross-sectional | Japan | Plasma | CD outpatients and age- and sex-matched HC subjects | CD | CD: 28 HC: 46 | CD: 32 HC: NR | CD: 57.1 HC: NR | CD: 20.5 ± 0.4 HC: 21.0 ± 0.7 | NR | Although no difference in ghrelin levels was found between CD patients and Helicobacter pylori–negative HC subjects, ghrelin was significantly lower in H. pylori–positive HC subjects compared with CD patients (P < .01) and negative HC subjects (P < .05). |
| Ortega Moreno et al29 | 2020 | Cross-sectional | Spain | Serum | CD patients and HC subjects | CD | CD: 40 HC: 36 | CD: 45.6 ± 12.6 HC: 51.4 ± 15.1 | CD: 47.5 HC: 44.4 | CD: 25.1 ± 4.1 HC: 24.4 ± 3.9 | NR | No significant difference was found between CD patients and HC subjects in ghrelin concentration (P = .07). |
| Peracchi et al9 | 2006 | Cross-sectional | Italy | Serum | IBD patients and HC subjects | UC CD | UC: 53 CD: 43 HC: 40 | IBD: 48.4 ± 16 HC: 42 ± 14 | IBD: 60.4 HC: 50.0 | IBD: 23.2 ± 3.2 HC: 22.1 ± 2.5 | NR | Ghrelin levels were significantly higher in active IBD compared with inactive IBD and HC subjects (P < .001 for both comparisons), while no difference was found between UC and CD. |
| Piquer et al30 | 2006 | Cross-sectional | France | Plasma | IBD patients and HC subjects | UC CD | UC: 3 CD: 18 HC: 28 | IBD: 29.5 ± 9.5 HC: 30.9 ± 9.2 | IBD: 52.4 HC: NR | IBD: 22.5 ± 5.8 HC: 21.6 ± 2.0 | NR | No significant difference was found in ghrelin levels between active IBD, quiescent IBD, and HC subjects (P > .05). |
| Sales et al31 | 2019 | Prospective | Brazil | Serum | IBD patients | UC CD | UC: 13 CD: 14 | IBD: 47.0 ± 14.5 | IBD: 40.7 | IBD: 25.4 ± 4.7 | NR | No significant difference was found in ghrelin levels between IBD patients with and without gastroduodenal symptoms (P > .05). |
| Sung et al35 | 2008 | Prospective | United Kingdom | Plasma | CD patients | CD | CD: 15 | CD: 31.5 ± 9.8 | CD: 66.7 | CD: 22.9 ± 3.4 | NR | About a 25% increase in total ghrelin levels was found after infliximab while des-acyl and acylated ghrelin levels remained unchanged. |
| Trejo-Vazquez et al33 | 2018 | Case-control | Mexico | Serum | IBD patients and HC subjects | UC CD | UC: 23 CD: 11 HC: 19 | IBD: 54.8 ± 15.1 HC: 53.2 ± 9.6 | IBD: 41.2 HC: 15.8 | IBD: 27.6 ± 5.9 HC: 28.4 ± 6.5 | NR | No significant difference was found in ghrelin levels between patients with CD, patients with UC, and HC subjects (P = .745). |
| Zhang et al34 | 2012 | Cross-sectional | China | Serum | Active UC patients and HC subjects | UC | UC: 54 HC: 25 | NR | NR | NR | NR | Serum ghrelin levels were significantly higher in patients with active UC compared with HC subjects (P = .041). |
Values are mean ± SD, unless otherwise indicated.
Abbreviations: AUC, area under the receiver-operating characteristic curve; BMI, body mass index; CD, Crohn’s disease; CDRx, medically treated Crohn's disease patients; CI, confidence interval; HC, healthy control; IBD, inflammatory bowel disease; NR, not reported; UC, ulcerative colitis.
Characteristics of studies evaluating ghrelin or obestatin levels in IBD patients.
| Author . | Year . | Design . | Location . | Specimen . | Population . | IBD type(s) . | Sample size . | Age (y) . | % Male . | BMI (kg/m2) . | Mean disease duration (y) . | Main findings . |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Alexandridis et al14 | 2009 | Cross-sectional | Greece | Serum | IBD patients | UC CD | UC: 22 CD: 31 | UC: 45.4 ± 14.8 CD: 40.3 ± 12.6 | NR | UC: 25.1 ± 3.3 CD: 23.4 ± 3.3 | UC: 10.6 ± 9.3 CD: 5.3 ± 5.2 | Significantly higher ghrelin values and significantly lower obestatin/ghrelin were found in active IBD compared with patients in remission. |
| Ates et al8 | 2008 | Prospective | Turkey | Serum | IBD patients and age-, sex, and BMI-matched HC subjects | UC CD | UC: 34 CD: 25 HC: 30 | UC: 38.3 ± 12.6 CD: 39.6 ± 12.4 HC: 36.1 ± 12.8 | UC: 58.8 CD: 56.0 HC: 60.0 | UC: 23.6 ± 3.9 CD: 23.3 ± 4.5 HC: 25.8 ± 3.2 | UC: 6.5 ± 6.3 CD: 6.4 ± 6.3 | No difference was found between UC, CD, and control subjects. However, ghrelin levels were significantly higher in active disease compared with remission in both UC and CD patients (P < .001). |
| Cekic et al26 | 2014 | Cross-sectional | Turkey | Serum | IBD patients | UC CD | UC: 52 CD: 33 | IBD: 42.8 ± 10.2 | IBD: 50.6 | NR | NR | Ghrelin levels were significantly higher in active IBD compared with remission and in subgroups of IBD. The AUC for establishing disease severity using ghrelin was 0.934 (95% CI, 0.884-0.984). |
| Ghomraoui et al49 | 2017 | Case-control | Saudi Arabia | Plasma | IBD patients and HC subjects | UC CD | UC: 11 CD: 20 HC: 41 | IBD: 32.3 ± 11.8 HC: 29.2 ± 10.2 | IBD: 32.3 HC: 41.5 | IBD: 24 ± 8.5 HC: 28.1 ± 6.9 | NR | Ghrelin levels were significantly higher in active disease IBD compared with remission (P = .02). |
| Jung et al15 | 2015 | Cross-sectional | Korea | Serum | UC patients | UC | UC: 21 | UC: 46.8 ± 14.2 | UC: 61.9 | UC: 21.8 ± 3.6 | UC: 3.0 ± 2.7 | Ghrelin levels were significantly higher in active disease compared with remission of the disease (P = .001), while obestatin was comparable between groups (P = .325). Finally, the obestatin/ghrelin ratio was significantly higher in remission of disease compared with active UC (P = .001). |
| Karmiris et al7 | 2006 | Prospective | Greece | Serum | IBD patients and age- and sex-matched HC subjects | UC CD | UC: 46 CD: 54 HC: 60 | UC: 46 CD: 37 HC: 36 | UC: 58.0 CD: 42.0 | UC: 25.5 CD: 24.0 | UC: 9.5 CD: 5.3 | Serum ghrelin levels were significantly higher in IBD patients compared with HC subjects (P < .0001). |
| Kim et al16 | 2017 | Retrospective | Korea | Serum | CD patients with more than 2 y disease duration | CD | CD: 153 | CD: 36.1 ± 10.0 | CD: 81.0 | CD: 20.6 ± 1.0 | CD: 10.2 ± 4.0 | Serum ghrelin levels were not different between CD patients with remission and active disease (P = .574). |
| Koutroubakis et al13 | 2011 | Prospective | Greece | Serum | IBD patients | UC CD | UC: 54 CD: 64 | UC: 42 CD: 36 | UC: 44.4 CD: 43.8 | NR | UC: 8.3 CD: 9.8 | Ghrelin levels were significantly higher in IBD patients with osteoporosis compared with IBD patients with osteopenia and normal IBD (P = .038). |
| Lönnkvist et al12 | 2011 | Prospective | Sweden | Plasma | CD patients and HC subjects | CD | CD: 22 HC: 10 | UC: 38 HC: NR | NR | NR | UC: 12.3 | Plasma ghrelin reduced after infliximab at initial and 6-mo follow-up (P < .05 and P = .06, respectively), while it was comparable to control subjects at visits (P > .05). |
| Lv et al27 | 2023 | Cross-sectional | China | Serum | UC patients and HC subjects | UC | UC: 90 HC: 40 | UC: 39.7 ± 10.6 HC: 39.8 ± 10.5 | UC: 56.7 HC: 55.0 | NR | NR | Ghrelin levels were significantly lower in UC patients (P < .001), and active disease patients had lower ghrelin levels compared with patients in the remission group and healthy control subjects (P < .001). Ghrelin acted as an acceptable marker for diagnosing active UC (AUC, 0.788; 95% CI, 0.690-0.894). |
| Moran et al28 | 2013 | Cross-sectional | United Kingdom | Plasma | Active CD patients and HC subjects | CD | CD: 17 CDRx: 6 HC: 13 | CD: 41.4 ± 4.8 CDRx: 56.2 ± 6.3 HC: 36.9 ± 3.0 | CD: 35.3 CDRx: 50.0 HC: 53.8 | HC: 25.3 ± 1.4 | NR | No change was found between CD patients and the HC group in the postprandial response of ghrelin (P = .1015). |
| Nishi et al10 | 2005 | Cross-sectional | Japan | Plasma | CD outpatients and age- and sex-matched HC subjects | CD | CD: 28 HC: 46 | CD: 32 HC: NR | CD: 57.1 HC: NR | CD: 20.5 ± 0.4 HC: 21.0 ± 0.7 | NR | Although no difference in ghrelin levels was found between CD patients and Helicobacter pylori–negative HC subjects, ghrelin was significantly lower in H. pylori–positive HC subjects compared with CD patients (P < .01) and negative HC subjects (P < .05). |
| Ortega Moreno et al29 | 2020 | Cross-sectional | Spain | Serum | CD patients and HC subjects | CD | CD: 40 HC: 36 | CD: 45.6 ± 12.6 HC: 51.4 ± 15.1 | CD: 47.5 HC: 44.4 | CD: 25.1 ± 4.1 HC: 24.4 ± 3.9 | NR | No significant difference was found between CD patients and HC subjects in ghrelin concentration (P = .07). |
| Peracchi et al9 | 2006 | Cross-sectional | Italy | Serum | IBD patients and HC subjects | UC CD | UC: 53 CD: 43 HC: 40 | IBD: 48.4 ± 16 HC: 42 ± 14 | IBD: 60.4 HC: 50.0 | IBD: 23.2 ± 3.2 HC: 22.1 ± 2.5 | NR | Ghrelin levels were significantly higher in active IBD compared with inactive IBD and HC subjects (P < .001 for both comparisons), while no difference was found between UC and CD. |
| Piquer et al30 | 2006 | Cross-sectional | France | Plasma | IBD patients and HC subjects | UC CD | UC: 3 CD: 18 HC: 28 | IBD: 29.5 ± 9.5 HC: 30.9 ± 9.2 | IBD: 52.4 HC: NR | IBD: 22.5 ± 5.8 HC: 21.6 ± 2.0 | NR | No significant difference was found in ghrelin levels between active IBD, quiescent IBD, and HC subjects (P > .05). |
| Sales et al31 | 2019 | Prospective | Brazil | Serum | IBD patients | UC CD | UC: 13 CD: 14 | IBD: 47.0 ± 14.5 | IBD: 40.7 | IBD: 25.4 ± 4.7 | NR | No significant difference was found in ghrelin levels between IBD patients with and without gastroduodenal symptoms (P > .05). |
| Sung et al35 | 2008 | Prospective | United Kingdom | Plasma | CD patients | CD | CD: 15 | CD: 31.5 ± 9.8 | CD: 66.7 | CD: 22.9 ± 3.4 | NR | About a 25% increase in total ghrelin levels was found after infliximab while des-acyl and acylated ghrelin levels remained unchanged. |
| Trejo-Vazquez et al33 | 2018 | Case-control | Mexico | Serum | IBD patients and HC subjects | UC CD | UC: 23 CD: 11 HC: 19 | IBD: 54.8 ± 15.1 HC: 53.2 ± 9.6 | IBD: 41.2 HC: 15.8 | IBD: 27.6 ± 5.9 HC: 28.4 ± 6.5 | NR | No significant difference was found in ghrelin levels between patients with CD, patients with UC, and HC subjects (P = .745). |
| Zhang et al34 | 2012 | Cross-sectional | China | Serum | Active UC patients and HC subjects | UC | UC: 54 HC: 25 | NR | NR | NR | NR | Serum ghrelin levels were significantly higher in patients with active UC compared with HC subjects (P = .041). |
| Author . | Year . | Design . | Location . | Specimen . | Population . | IBD type(s) . | Sample size . | Age (y) . | % Male . | BMI (kg/m2) . | Mean disease duration (y) . | Main findings . |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Alexandridis et al14 | 2009 | Cross-sectional | Greece | Serum | IBD patients | UC CD | UC: 22 CD: 31 | UC: 45.4 ± 14.8 CD: 40.3 ± 12.6 | NR | UC: 25.1 ± 3.3 CD: 23.4 ± 3.3 | UC: 10.6 ± 9.3 CD: 5.3 ± 5.2 | Significantly higher ghrelin values and significantly lower obestatin/ghrelin were found in active IBD compared with patients in remission. |
| Ates et al8 | 2008 | Prospective | Turkey | Serum | IBD patients and age-, sex, and BMI-matched HC subjects | UC CD | UC: 34 CD: 25 HC: 30 | UC: 38.3 ± 12.6 CD: 39.6 ± 12.4 HC: 36.1 ± 12.8 | UC: 58.8 CD: 56.0 HC: 60.0 | UC: 23.6 ± 3.9 CD: 23.3 ± 4.5 HC: 25.8 ± 3.2 | UC: 6.5 ± 6.3 CD: 6.4 ± 6.3 | No difference was found between UC, CD, and control subjects. However, ghrelin levels were significantly higher in active disease compared with remission in both UC and CD patients (P < .001). |
| Cekic et al26 | 2014 | Cross-sectional | Turkey | Serum | IBD patients | UC CD | UC: 52 CD: 33 | IBD: 42.8 ± 10.2 | IBD: 50.6 | NR | NR | Ghrelin levels were significantly higher in active IBD compared with remission and in subgroups of IBD. The AUC for establishing disease severity using ghrelin was 0.934 (95% CI, 0.884-0.984). |
| Ghomraoui et al49 | 2017 | Case-control | Saudi Arabia | Plasma | IBD patients and HC subjects | UC CD | UC: 11 CD: 20 HC: 41 | IBD: 32.3 ± 11.8 HC: 29.2 ± 10.2 | IBD: 32.3 HC: 41.5 | IBD: 24 ± 8.5 HC: 28.1 ± 6.9 | NR | Ghrelin levels were significantly higher in active disease IBD compared with remission (P = .02). |
| Jung et al15 | 2015 | Cross-sectional | Korea | Serum | UC patients | UC | UC: 21 | UC: 46.8 ± 14.2 | UC: 61.9 | UC: 21.8 ± 3.6 | UC: 3.0 ± 2.7 | Ghrelin levels were significantly higher in active disease compared with remission of the disease (P = .001), while obestatin was comparable between groups (P = .325). Finally, the obestatin/ghrelin ratio was significantly higher in remission of disease compared with active UC (P = .001). |
| Karmiris et al7 | 2006 | Prospective | Greece | Serum | IBD patients and age- and sex-matched HC subjects | UC CD | UC: 46 CD: 54 HC: 60 | UC: 46 CD: 37 HC: 36 | UC: 58.0 CD: 42.0 | UC: 25.5 CD: 24.0 | UC: 9.5 CD: 5.3 | Serum ghrelin levels were significantly higher in IBD patients compared with HC subjects (P < .0001). |
| Kim et al16 | 2017 | Retrospective | Korea | Serum | CD patients with more than 2 y disease duration | CD | CD: 153 | CD: 36.1 ± 10.0 | CD: 81.0 | CD: 20.6 ± 1.0 | CD: 10.2 ± 4.0 | Serum ghrelin levels were not different between CD patients with remission and active disease (P = .574). |
| Koutroubakis et al13 | 2011 | Prospective | Greece | Serum | IBD patients | UC CD | UC: 54 CD: 64 | UC: 42 CD: 36 | UC: 44.4 CD: 43.8 | NR | UC: 8.3 CD: 9.8 | Ghrelin levels were significantly higher in IBD patients with osteoporosis compared with IBD patients with osteopenia and normal IBD (P = .038). |
| Lönnkvist et al12 | 2011 | Prospective | Sweden | Plasma | CD patients and HC subjects | CD | CD: 22 HC: 10 | UC: 38 HC: NR | NR | NR | UC: 12.3 | Plasma ghrelin reduced after infliximab at initial and 6-mo follow-up (P < .05 and P = .06, respectively), while it was comparable to control subjects at visits (P > .05). |
| Lv et al27 | 2023 | Cross-sectional | China | Serum | UC patients and HC subjects | UC | UC: 90 HC: 40 | UC: 39.7 ± 10.6 HC: 39.8 ± 10.5 | UC: 56.7 HC: 55.0 | NR | NR | Ghrelin levels were significantly lower in UC patients (P < .001), and active disease patients had lower ghrelin levels compared with patients in the remission group and healthy control subjects (P < .001). Ghrelin acted as an acceptable marker for diagnosing active UC (AUC, 0.788; 95% CI, 0.690-0.894). |
| Moran et al28 | 2013 | Cross-sectional | United Kingdom | Plasma | Active CD patients and HC subjects | CD | CD: 17 CDRx: 6 HC: 13 | CD: 41.4 ± 4.8 CDRx: 56.2 ± 6.3 HC: 36.9 ± 3.0 | CD: 35.3 CDRx: 50.0 HC: 53.8 | HC: 25.3 ± 1.4 | NR | No change was found between CD patients and the HC group in the postprandial response of ghrelin (P = .1015). |
| Nishi et al10 | 2005 | Cross-sectional | Japan | Plasma | CD outpatients and age- and sex-matched HC subjects | CD | CD: 28 HC: 46 | CD: 32 HC: NR | CD: 57.1 HC: NR | CD: 20.5 ± 0.4 HC: 21.0 ± 0.7 | NR | Although no difference in ghrelin levels was found between CD patients and Helicobacter pylori–negative HC subjects, ghrelin was significantly lower in H. pylori–positive HC subjects compared with CD patients (P < .01) and negative HC subjects (P < .05). |
| Ortega Moreno et al29 | 2020 | Cross-sectional | Spain | Serum | CD patients and HC subjects | CD | CD: 40 HC: 36 | CD: 45.6 ± 12.6 HC: 51.4 ± 15.1 | CD: 47.5 HC: 44.4 | CD: 25.1 ± 4.1 HC: 24.4 ± 3.9 | NR | No significant difference was found between CD patients and HC subjects in ghrelin concentration (P = .07). |
| Peracchi et al9 | 2006 | Cross-sectional | Italy | Serum | IBD patients and HC subjects | UC CD | UC: 53 CD: 43 HC: 40 | IBD: 48.4 ± 16 HC: 42 ± 14 | IBD: 60.4 HC: 50.0 | IBD: 23.2 ± 3.2 HC: 22.1 ± 2.5 | NR | Ghrelin levels were significantly higher in active IBD compared with inactive IBD and HC subjects (P < .001 for both comparisons), while no difference was found between UC and CD. |
| Piquer et al30 | 2006 | Cross-sectional | France | Plasma | IBD patients and HC subjects | UC CD | UC: 3 CD: 18 HC: 28 | IBD: 29.5 ± 9.5 HC: 30.9 ± 9.2 | IBD: 52.4 HC: NR | IBD: 22.5 ± 5.8 HC: 21.6 ± 2.0 | NR | No significant difference was found in ghrelin levels between active IBD, quiescent IBD, and HC subjects (P > .05). |
| Sales et al31 | 2019 | Prospective | Brazil | Serum | IBD patients | UC CD | UC: 13 CD: 14 | IBD: 47.0 ± 14.5 | IBD: 40.7 | IBD: 25.4 ± 4.7 | NR | No significant difference was found in ghrelin levels between IBD patients with and without gastroduodenal symptoms (P > .05). |
| Sung et al35 | 2008 | Prospective | United Kingdom | Plasma | CD patients | CD | CD: 15 | CD: 31.5 ± 9.8 | CD: 66.7 | CD: 22.9 ± 3.4 | NR | About a 25% increase in total ghrelin levels was found after infliximab while des-acyl and acylated ghrelin levels remained unchanged. |
| Trejo-Vazquez et al33 | 2018 | Case-control | Mexico | Serum | IBD patients and HC subjects | UC CD | UC: 23 CD: 11 HC: 19 | IBD: 54.8 ± 15.1 HC: 53.2 ± 9.6 | IBD: 41.2 HC: 15.8 | IBD: 27.6 ± 5.9 HC: 28.4 ± 6.5 | NR | No significant difference was found in ghrelin levels between patients with CD, patients with UC, and HC subjects (P = .745). |
| Zhang et al34 | 2012 | Cross-sectional | China | Serum | Active UC patients and HC subjects | UC | UC: 54 HC: 25 | NR | NR | NR | NR | Serum ghrelin levels were significantly higher in patients with active UC compared with HC subjects (P = .041). |
Values are mean ± SD, unless otherwise indicated.
Abbreviations: AUC, area under the receiver-operating characteristic curve; BMI, body mass index; CD, Crohn’s disease; CDRx, medically treated Crohn's disease patients; CI, confidence interval; HC, healthy control; IBD, inflammatory bowel disease; NR, not reported; UC, ulcerative colitis.
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