Ghrelin, leptin and insulin in cirrhotic children and adolescents: relationship with cirrhosis severity and nutritional status

OBJECTIVE

Ghrelin, leptin, and insulin concentrations are involved in the control of food intake and they seem to be associated with anorexia-cachexia in cirrhotic patients. The present study aimed to investigate the relationship between the nutritional status and fasting ghrelin, leptin and insulin concentrations in pediatric cirrhotic patients.

METHODS

Thirty-nine patients with cirrhosis and 39 healthy controls aged 0-15 years matched by sex and age were enrolled. Severity of liver disease was assessed by Child-Pugh classification, and Pediatric for End Stage Liver Disease (PELD) or Model for End-stage Liver Disease (MELD) scores. Blood samples were collected from patients and controls to assay total ghrelin, acyl ghrelin, leptin and insulin by using a commercial ELISA kit. Anthropometry parameters used were standard deviation score of height-for-age and triceps skinfold thickness-for-age ratio. A multiple linear regression analysis was used to determine the correlation between dependent and independent variables.

RESULTS

Acyl ghrelin was significantly lower in cirrhotic patients than in controls [142 (93-278) pg/mL vs 275 (208-481) pg/mL, P=0.001]. After multiple linear regression analysis, total ghrelin and acyl ghrelin showed an inverse correlation with age; acyl ghrelin was associated with the severity of cirrhosis and des-acyl ghrelin with PELD or MELD scores ≥15. Leptin was positively correlated with gender and anthropometric parameters. Insulin was not associated with any variable.

CONCLUSION

Low acyl ghrelin and high des-acyl ghrelin concentrations were associated with cirrhosis severity, whereas low leptin concentration was associated with undernourishment in children and adolescents with cirrhosis.

Effect of isosporiasis prevention with toltrazuril on long-term pig performance

The efficacy of toltrazuril treatment was assessed in two experiments in Polish swine herds. Experiment 1 included a toltrazuril treatment group, Group A (n = 410), and untreated control, Group B (n = 386). Time to sale in Group A was 108 days versus 120 days for Group B, with average body weights at sale of 114.2 kg and 108.8 kg, respectively (P < 0.05). In experiment 2, the health status and body weight gain of 238 piglets treated with toltrazuril (Group D) were compared to 235 untreated piglets (Group K). A similar difference was observed in average body weights of slaughtered animals, being on average 104 kg in Group D and 101 kg in Group K (P < 0.01). Animals from Group D were slaughtered 5 days earlier than animals from Group K (day 166 versus day 171). Data from clinical trials suggest treatment of coccidiosis with toltrazuril offering potential for improved animal welfare and yields, however this has remained unproven in field conditions in large swine production facilities. The present study confirms the efficacy of toltrazuril treatment when used in the field and the subsequent positive impact on time to weaning, time to market, and on weight gain at all time points.

Linked outbreaks and control of porcine reproductive and respiratory syndrome and postweaning multisystemic wasting syndrome in a pig farm in Poland

In a newly established farrow-to-finish farm (porcine reproductive and respiratory virus [PRRSV]-free, porcine circovirus type 2 [PCV-2]-infected), reproductive failure was seen seven months after population. The conception rate dropped from 89 to 51 per cent, and the abortion rate increased from 0.5 to 11 per cent. The following month, characteristic lesions of postweaning multisystemic wasting syndrome (PMWS) and elevated mortality were observed in weaned pigs. Laboratory examinations confirmed reproductive failure due to PRRSV and PMWS associated with apparent activation of the PCV-2 circulating in the farm. The herd was closed for replacement and a number of measures to improve hygiene, environmental conditions and feeding were applied. The abortion rate returned to preoutbreak levels four months after the beginning of the PRRS outbreak and the conception rate returned to normal four months later. Slower improvement was observed regarding the PMWS outbreak, with PMWS-related losses disappearing nine months after the detection of PMWS. Analysis of seroconversion profiles to PCV-2 and PRRSV during the outbreak and after its control indicated that while PRRSV was eliminated from sows and weaners by the control measures, the time of PCV-2 infection was unchanged and occurred at seven weeks of age during the PMWS outbreak as well as after its elimination. However, the elimination of PMWS from the herd coincided with increased levels of maternally derived antibodies to PCV-2 in one- to five-week-old pigs and faster serological responses to infection with PCV-2.