Correlation between nutritional status and plasma levels of ghrelin and leptin in inflammatory bowel disease patients

ABSTRACT Background: Leptin and ghrelin regulate appetite and inflammation, but their role in inflammatory bowel disease (IBD) is unclear. This study examined the associations between serum leptin and ghrelin levels and IBD activity, nutritional indicators, and inflammatory markers. Materials and Methods: A case–control study included 55 IBD patients (31 ulcerative colitis and 24 Crohn’s disease [CD]) and 55 healthy controls. Disease activity was assessed using the Mayo score, CD activity index, and fecal calprotectin (FC). Serum leptin and ghrelin were measured via enzyme-linked immunosorbent assay. Body mass index (BMI), total nutritional score, folic acid, and inflammatory markers were recorded. Group comparisons, Spearman’s correlations, and receiver operating characteristic (ROC) analyses were conducted. Results: A total of 110 individuals were analyzed (34 active IBD, 21 inactive IBD, and 55 controls). Demographics were similar across groups. Hormone levels differed significantly by disease activity ( P < 0.001). Leptin level was highest in controls and lowest in active IBD; ghrelin level was highest in controls, intermediate in active IBD, and lowest in inactive IBD. Ghrelin showed negative correlations with BMI, nutritional score, and alkaline phosphatase and a positive correlation with folic acid. Leptin correlated positively with BMI, erythrocyte sedimentation rate, and FC and negatively correlated with nutritional score. ROC curves demonstrated predictive value for nutritional decline for both leptin (area under the curve [AUC] 0.744– P < 0.001) and ghrelin (AUC = 0.64, P = 0.008). Conclusion: Leptin and ghrelin in IBD were associated with inflammatory markers and nutritional status, showing stronger links with inflammation. Their combined measurement may aid understanding of metabolic changes in active disease, though longitudinal studies are needed.