الفهرس 
GHRELINOnly 14 pages are availabe for public view
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Abstract
The increasing prevalence of metabolic syndrome and the consequent cardiovascular diseases, like atherosclerotic diseases and Type 2 diabetes has stimulated an active search for novel risk factors. The hormones regulating energy balance are of special interest as potential risk factors for metabolic syndrome and Type 2 diabetes. Ghrelin is a peptide hormone from stomach with growth hormone releasing activity. It is also able to modify glucose and insulin metabolism, blood pressure levels, adipogenesis, and inflammatory processes in experimental conditions. Whether ghrelin has a role in the development metabolic syndrome and the associated diseases, is not known
Ghrelin is an orexigenic hormone released from the stomach that stimulates the release of growth hormone and has been shown to inhibit the release of insulin. Evidence from rodent models of diabetes and perturbed ghrelin signaling suggest that ghrelin plays a role in regulating glucose homeostasis. Ghrelin may act as a paracrine signaling factor within the pancreas in the control of β-cell function. Ghrelin levels are reduced in obesity and diabetes, and insulin resistance has been linked to mutations in the ghrelin precursor molecule. Ghrelin appears to exert antioxidant and antiapoptotic effects upon endothelial and nervous tissue, and may help to protect against diabetes-related disease. The role of ghrelin in the development of diabetes and its potential utility as a treatment for some of the effects of diabetes remain unclear and require further study
Our study was conducted on 40 patients divided into 2 groups , group 1 : 20 patients with type 2 diabetes and chronic heart failure ,group 2 : 20 non diabetic patients with chronic heart failure compared with 20 normal healthy subjects as a control group (group 3). All subjects were subjected to full history taking , thorough clinical examination , anthropometric evaluation, laboratory investigations including : Fasting and postprandial blood glucose ,HBA1C% , Liver function tests, Kidney function tests, Ghrelin level by ELISA and Echocardiography .
The aim of this work was to study the relationship between ghrelin levels in type 2 diabetic patients and in patients with chronic heart failure.
We found that that patients with DM had a lower EF than patients with no history of DM , and that there was no statistically significant difference between groups as regard Ghrelin level, yet there was a trend toward higher level of Ghrelin in patients with CHF.
Our results also showed that there was a significant positive correlation between liver enzymes and Ghrelin level in all patients, and in diabetic subgroup, and a significant negative correlation between HBA1C and Ghrelin in control group.
In conclusion, our study showed that diabetic patients had lower Ghrelin levels and lower EF in comparison to non diabetics and this may contribute to the widespread cardiovascular complications and increased CV morbidity and mortality in diabetic patients.
We also found that ghrelin levels may be related to blood sugar comtrol, fibrogenesis and liver injury which may highlight a possible new diagnostic tool for diabetes and diabetic complcations and the possible therapeutic role of Ghrelin in diabetic patients and in patients with Metabolic Syndrome.
The multifunctional nature of ghrelin makes it an interesting pharmacological target for various diseases. Future researches are needed to evaluate the efficacy of ghrelin as a new biomarker and prognostic tool and for exploring its therapeutic potential in patients suffering from CHF.