Dynamics of the Eating Behavior Hormone Levels Leptin andчGhrelin in Patients with Gastroesophageal Reflux Disease Depending on the Treatment Strategy

The aim of the work: to assess leptin and ghrelin levels in patients with gastroesophageal reflux disease, to assess their dynamics and to determine their relationship with body mass index. Materials and Methods. The study included the examination and treatment of 90 patients with gastroesophageal reflux disease (GERD). Laparoscopic total fundoplication in a modification of the Short Floppy Nissen technique was performed in 35 patients. Drug therapy was prescribed to 35 patients. The comparison group consisted of 20 healthy volunteers. The groups of patients and healthy control subjects were matched for gender and age. Venous blood for the study was collected from patients in the comparison group, and in the groups before and after surgical or therapeutic treatment, as well as from all patients 2–3 months after treatment. Ghrelin (Ghrelin, ELISA, BMS2192, Ebioscience) and leptin (Leptin, Sensitiv ELISA, KAC2281, Ebioscience) were tested on the ImmunoChem-2100 enzyme-linked immunosorbent assay (ELISA) (USA). Results. The median ghrelin level in healthy participants was 21.2 ng/mL [5.44; 22.7], leptin 0.8 ng/mL [0.22; 1.5], and body mass index (BMI) 21 kg/m² [18; 25]. In healthy volunteers, a strong positive correlation was observed between leptin levels and BMI (r=0.666, p=0.001). The correlation between ghrelin and leptin (r=-0.373, p=0.105) and between ghrelin and BMI (r=-0.296, p=0.206) was not statistically significant. Significant differences were found in concentrations of the metabolic hormones leptin and ghrelin, as well as in BMI, in patients with GERD compared to healthy volunteers. Changes in these parameters were also observed after surgical and therapeutic treatment. A positive correlation between leptin concentration and BMI was established in all groups. Patients had increased leptin levels and decreased ghrelin levels before surgery and before the start of therapy compared to the control group. After surgery, there was a significant increase in ghrelin levels compared to preoperative levels, while leptin concentrations decreased. A moderate negative correlation was found between ghrelin levels and BMI after therapeutic treatment. Correlation analysis demonstrated a consistent relationship between leptin and BMI in all study groups. The contribution of ghrelin to body weight regulation appeared to be more context-dependent, varying depending on the stage of treatment and the patient's energy status. Conclusions. Patients with gastroesophageal reflux disease have an increased leptin levels and decreased ghrelin levels. The consistent association between leptin and body mass index in all groups confirms its key role as a marker of adipose tissue, while the greater variability of ghrelin indicates its sensitivity to changes in energy balance and to the effects of treatment. The more pronounced hormonal dynamics observed after surgery compared with therapeutic treatment suggests that antireflux surgery may affect not only reflux mechanisms but also metabolic regulation.