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Asociación Mexicana de Gastroenterología

2005, Número 4

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Rev Gastroenterol Mex 2005; 70 (4)


Ghrelina: más allá de la regulación del hambre

Milke GMP

Idioma: Español
Referencias bibliográficas: 75
Paginas: 465-473
Archivo PDF: 64.36 Kb.


RESUMEN

El hombre ingiere alimentos para mitigar el hambre (mediada por parámetros fisiológicos y bioquímicos), satisfacer su apetito (sensación subjetiva) y por razones psicosociales. Los biomarcadores de “saciación” (dejar de comer) son distensión gástrica y hormonas (CCK, GLP-1) y los de “saciedad” (empezar a comer), la termogénesis inducida por alimentos, temperatura corporal, glucemia y también hormonas (insulina, leptina y ghrelina). Asimismo, están implicados en el hambre el metabolismo oxidativo/composición corporal, triptofano/serotonina, séricos y citocinas proinflamatorias. Actualmente, la ghrelina es el único orexigénico circulante con potencial regulador del hambre/peso corporal. Es un neuropéptido gastrointestinal (ligando endógeno del receptor del secretagogo de la GH) aislado recientemente de la mucosa oxíntica producida principalmente en el estómago. Su concentración sanguínea depende de la dieta, hiperglucemia y adiposidad/leptina. Se secreta 1-2 horas preprandialmente y su concentración disminuye drásticamente en el posprandio. Actúa en hipotálamo lateral y teóricamente inhibe la secreción de citocinas proinflamatorias y antagoniza a la leptina. La ghrelina fisiológicamente aumenta el consumo de alimentos y estimula la adipogénesis, la motilidad gastrointestinal y secreción ácida gástrica y tiene otras funciones hormonales y cardiovasculares. Está disminuida en obesidad masiva, esteatohepatitis no alcohólica, síndrome de ovario poliquístico, acromegalia, hipogonadismo, envejecimiento, síndrome de intestino corto y artritis reumatoide y aumentada en anorexia primaria o secundaria, inanición, enfermedad hepática crónica y enfermedad celíaca. La administración cerebral y peritoneal de ghrelina (ratas) y sistémica (ratas y personas sanas, con cáncer o diálisis peritoneal) promueve el consumo de alimentos y aumenta la adiposidad, hecho de gran importancia terapéutica en pacientes con anorexia.


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