Serum levels of ghrelin, tumor necrosis factor-A [TNF- A], and lnterleukin-6 [IL-6] in infants and children with congenital heart disease

ABSTRACT

Ghrelin increases food intake, body weight, and growth hormone secretion. The cause of growth retardation in congenital heart disease [CHD] is multifactorial. The aim of this study was to estimate serum levels of ghrelin, tumor necrosis factor-a [TNF-alpha], and interleukin-6 [IL-6] ih infants and children with CHD, compared with levels in age-matched controls, and to correlate the levels ofghrelin with TNF- alpha, and IL-6. We measured serum ghrelin, TNF- alpha and IL 6 levels using ELISA in 60 patients with CHD [40 acyanotic and 20 cyanotic] and in 20 control subjects. Our results showed that patients with CHD, whether compiled in one group or classified into acyanotic and cyanotic, had significantly higher serum ghrelin TNF- alpha, and IL-6 than controls [p = 0.000]. Serum levels of ghrelin and TNF- alpha in the acyanotic patients were significantly higher than in the cyanotic patients [p = 0.000]. On the other hand, there was no significant difference in serum levels of IL-6 between the acyanotic and the cyanotic patients [p = 0.126]. In acyanotic and cyanotic patients with CHD, there was a positive correlation between ghrelin and TNF- alpha [r = 0.424; p = 0.006 and r = 0.577; p = 0.008, resp.]. Ghrelin levels were not correlated with IL-6 in the acyanotic and cyanotic patients with CHD [r = -0.211; p = 0.216 and r = -0.341; p = 0.08, resp.]. Serum ghrelin, TNF- alpha, and IL-6 levels are elevated in patients with CHD whether acyanotic or cyanotic. Increased ghrelin levels represent malnutrition and growth retardation in these patients. The relation of ghrelin with TNF- alpha may be explained by the possible effect of chronic congestive heart failure and chronic shunt hypoxemia