The Relations Among Serum Ghrelin, Motilin and Gastric Emptying and Autonomic Function in Autoimmune Gastritis

Background: Gastric emptying (GE) of solids is delayed and autonomic dysfunction is detected in autoimmune gastritis (AIG). The goals of this study were to: (1) compare serum levels of ghrelin and motilin in subjects with delayed and normal GE and (2) investigate whether circulating antimyenteric antibodies (CM), serum ghrelin levels and motilin levels have any effect on autonomic function. Materials and Methods: Noninvasive cardiovascular reflex tests were used in order to evaluate the autonomic function. GE was evaluated by a standard 2-hour scintigraphic test. Serum ghrelin and motilin levels were tested by enzyme-linked immunosorbent assay and CM were tested by immunofluorescence. Results: The serum ghrelin and motilin levels in the patients with delayed GE (n = 22) were significantly decreased compared to the normal GE patients (n = 19), (67.55 +/- 8.81 versus 126.79 +/- 25.81 pg/mL, P < 0.001 and 279.59 +/- 111.12 versus 500.42 +/- 155.95 pg/mL, respectively, P < 0.001). Whereas, the serum ghrelin and motilin levels in the patients with deranged autonomic function (n = 26) were significantly decreased compared to the patients with normal autonomic function (n = 15), (80.73 +/- 28.46 versus 127.79 +/- 28.06 pg/mL, P < 0.001 and 316.92 +/- 160.47 versus 490.20 +/- 141.02 pg/mL, P < 0.001, respectively). None of the patients were positive for CM. Conclusions: Ghrelin and motilin levels in AIG subjects with delayed GE and deranged autonomic function were significantly decreased. The decrease in serum ghrelin and plasma motilin levels in AIG suggest their potential role in the delayed GE observed in these subjects.