REGULATION OF THE SERUM GHRELIN LEVEL IN PATIENTS WITH TYPE 2 DIABETES MELLITUS INFECTED WITH HELICOBACTER PYLORI

Abstract

The article describes and analyzes the role of ghrelin in patients with type 2 diabetes mellitus (T2DM) infected with Helicobacter pylori (HP). The aim — to assess the factors affecting serum ghrelin levels in patients with type 2 diabetes mellitus depending on Helicobacter pylori infection. Materials and methods. 70 patients with non-insulin-dependent T2DM, according to the recom­ mendations of the American Diabetes Association, aged 51 to 57 years, were included in the study. All patients underwent a determination of the level of glycosylated hemoglobin (HbA1c), serum ghrelin (GHR), a fecal test for the determination of Helicobacter pylori antigen (HP) and anti-HP antibodies. Depending on the presence of HP in patients, they are divided into two groups: group I — HP-positive patients with T2DM (n = 50) and group II — HP-negative patients with T2DM (n = 20). The control group consisted of 20 practically healthy people, aged from 49 to 56 years. Results. The obtained results indicate that patients with T2DM and HP+ have a significantly higher level of the main parameters of carbohydrate metabolism (fasting blood glucose, HbA1c, HOMA index of insulin resistance (I-HOMA)), and GHR level is significantly lower in group 1 (T2DM, HP+) compared to group 2 (T2DM, HP-). The results of the regression analysis established that with a decrease in the level of anti-HP IgG (–0.919756) by 1 unit, serum ghrelin will increase by 0.524530 (р = 0.0000001), with a decrease in the level of fasting blood glucose (–4.67237) by 1 unit, GHR will increase by 0.505678 (p = 0.0000001), with a decrease in the level of glycosylated hemoglobin (–0.650397) by 1 unit, GHR will increase by 0.127541 (p = 0.002). With a decrease in the I-HOMA (–2.71500) by 1 unit in group 2, GHR will increase by 0.766778 (р = 0.02), with a decrease in the level of I-HOMA (–3.74895) by 1 unit in group 1, GHR will increase by 0.286003 (p = 0.0000001). A correlation was also established between fasting blood glucose and anti-HP IgG (r = 0.96875; p = 0.01); between the levels of insulin resistance and anti-HP IgG (r = 0.95882; p = 0.01). Conclusions. The level of serum ghrelin is significantly lower in patients with type 2 diabetes mellitus compared to individuals without diabetes and is significantly dependent on the main indicators of carbohydrate metabolism. Infection with Helicobacter pylori leads to a decrease in the level of ghrelin in blood serum and an increase in insulin resistance and gradual decompensation of type 2 diabetes mellitus.