Long-term effect of ghrelin on nutritional status and functional capacity in the elderly: A population-based cohort study

Abstract

Background Ghrelin stimulates GH release and hunger at a central level. Ghrelin declines with age, which may be partially responsible for functional impairment and frailty. Objective To describe the evolution of nutritional status and functional capacity of noninstitutionalized old people over a 2-year period, as well as to evaluate the relationship between ghrelin and long-term changes in nutritional and functional status in this population. Design A population-based cohort study was designed in which 313 randomly selected persons, 70 years old or older, were followed for a 2-year period. Functional (Barthel and Guralnik scores and hand grip) and nutritional (MNA-SF, weight and BMI) assessments were performed during basal and 2-year follow-up visits. Ghrelin and hormonal components of the gonadotrophe and somatotrophe axis were determined. Results During follow-up, 13% of men and 20% of women showed a >5% weight loss, and the nutritional status of 18% of men and 39% of women deteriorated. Men lost 12·1% and women lost 9·7% of their initial hand grip strength. In men, low basal ghrelin levels were associated with higher weight loss and poorer hand grip but not with the MNA-SF measure, whereas in women, low basal ghrelin levels were associated with a decline in nutritional status (MNA-SF) but not with weight loss and hand grip decline. Conclusion Low ghrelin levels have been related to worsening nutritional status in a 2-year follow-up period in people 70 years old or older, which suggests this hormone could become a useful therapeutic target in the elderly. © 2010 Blackwell Publishing Ltd.