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Journal of Tropical Pediatrics Advance Access published online on June 2, 2009
Journal of Tropical Pediatrics, doi:10.1093/tropej/fmp036
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© The Author [2009]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Serum Levels of Ghrelin, Tumor Necrosis Factor-{alpha} and Interleukin-6 in Infants and Children with Congenital Heart Disease

Mohamed Farouk Afifya, Gamal B. Mohameda, Mohamed Abd El-Mabouda and Esmat A. Abdel-Latifb

a Department of Pediatrics, Faculty of Medicine, Al-Minya University, Egypt
b Department of Clinical Pathology, Faculty of Medicine, Al-Minya University, Egypt

Correspondence: Gamal B. Mohamed, Department of Pediatrics, Faculty of Medicine, Al-Minya University, Egypt. E-mail: <gamalbaheeg{at}yahoo.com>.


  Abstract

Objective: To estimate serum levels of ghrelin, tumor necrosis factor-{alpha} (TNF-{alpha}) and interleukin-6 (IL-6) in infants and children with congenital heart disease (CHD), compared with levels in age-matched controls, and to correlate the levels of ghrelin with TNF-{alpha} and IL-6.

Design: Case–control study.

Setting: Suzan Moubarak Hospital of Al-Minya University, Egypt.

Patients: 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.

Results: Our results showed that patients with CHD, regardless of the presence or absence of cyanosis, 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, respectively). Ghrelin levels were not correlated to IL-6 in the acyanotic and cyanotic patients with CHD (r = –0.211; p = 0.216 and r = –0.341; p = 0.08, respectively).

Conclusion: 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.

Key Words: ghrelin • cytokines • children • congenital heart disease


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