O039 - GHRELIN’S ROLE IN REGULATING FOOD INTAKE AMONG INPATIENTS AT NUTRITIONAL RISK: A SECONDARY ANALYSIS OF THE RANDOMIZED CLINICAL TRIAL EFFORT

O039

GHRELIN’S ROLE IN REGULATING FOOD INTAKE AMONG INPATIENTS AT NUTRITIONAL RISK: A SECONDARY ANALYSIS OF THE RANDOMIZED CLINICAL TRIAL EFFORT

C. Wunderle¹, K.-H. Urbach^1,2, V. Haller^1,*, P. Tribolet^1,3,4, T. A. Lutz⁵, C. Köster-Hegmann⁵, Z. Stanga⁶, B. Mueller^1,2, P. Schuetz^1,2

¹Division of General Internal and Emergency Medicine, Division of Endocrinology, Diabetes and Metabolism, Kantonsspital Aarau, 5001 Aarau, ²Medical Faculty of the University of Basel, 4056 Basel, ³Department of Health Professions, Bern University of Applied Sciences, 3008 Bern, Switzerland, ⁴Department of Nutritional Sciences, University of Vienna, 1090 Vienna, Austria, ⁵Vetsuisse Faculty, Institute of Veterinary Physiology, University of Zurich , 8057 Zurich, ⁶Division of Diabetes, Endocrinology, Nutritional Medicine, and Metabolism, Bern University Hospital and University of Bern, 3010 Bern, Switzerland

Rationale: Ghrelin is an orexigenic hormone that stimulates food intake by hypothalamic actions. There is limited data on its circulating levels, pathophysiological role, and prognostic and therapeutic potential in disease-related malnutrition.

Methods: This secondary analysis of the randomized controlled Effect of early nutritional support on Frailty, Functional Outcomes, and Recovery of malnourished medical inpatients Trial (EFFORT) investigated the association of admission ghrelin levels in terms of malnutrition phenotype, nutritional target achievement, and treatment response. The primary outcome was 30-day all-cause mortality.

Results: A total of 997 patients with available ghrelin measurements were included. We found a positive association between malnutrition severity according to the Nutritional Risk Screening (NRS) and ghrelin levels upon admission. Patients with high ghrelin levels had a 1.4-fold greater chance of reaching nutritional targets during hospitalization compared to those with lower levels (adjusted OR 1.40 [95% CI 1.01 to 1.93], p=0.045). High ghrelin levels were not associated with mortality, complications, or adverse events, and both high and low ghrelin groups showed a similar response to nutritional therapy.

Conclusion: We observed an inverse association between elevated ghrelin levels and nutritional intake at admission. A hypothesis may be generated that the hormone’s orexigenic effect is impaired due to ghrelin resistance or insensitivity. However, under nutritional therapy, patients with high ghrelin levels were more likely to achieve nutritional targets. Ghrelin analogs during hospitalization may help overcome this presumed resistance and facilitate beneficial nutritional intake in this vulnerable patient population.

Disclosure of Interest: None declared