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Could Ghrelin Expression Regulate Diastolic Cardiac Function in Type 2 Diabetic Obese Patients?

Celestino Sardu¹, Nunzia D'Onofrio², Maria Consiglia Trotta²

¹Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy.

Diabetes/Metabolism Research and Reviews

|May 5, 2025

Summary

Abdominal fat excision in obese patients with type 2 diabetes mellitus (T2DM) reduced inflammation and improved left ventricle diastolic function (LV-DF). This intervention increased serum ghrelin and specific microRNAs (miRs) linked to LV-DF normalization.

Keywords:

MicroRNA SIRT1 abdominal fat abdominoplasty ghrelin obesity oxidative stress

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Area of Science:

Cardiology
Endocrinology
Metabolic Syndrome

Background:

Adipose tissue cytokines, sirtuin-1 (SIRT1), and microRNAs (miRs) influence left ventricle diastolic function (LV-DF).
Ghrelin may modulate these pathways in obese patients with type 2 diabetes mellitus (T2DM).

Purpose of the Study:

Investigate ghrelin expression in T2DM obese patients post-abdominal fat excision.
Assess the impact of abdominal fat excision on LV-DF normalization at one-year follow-up.

Main Methods:

Two hundred and two T2DM obese patients undergoing abdominoplasty were categorized by LV-DF severity.
Tissue and serum markers, including inflammatory cytokines, SIRT1, sodium-glucose-transporter-two (SGLT2), ghrelin, and miRs (miR-21, miR-92, miR-126), were analyzed.

Main Results:

Patients with LV-diastolic dysfunction exhibited higher inflammation, SGLT2, and altered miR expression, with lower SIRT1.
Abdominal fat excision led to reduced inflammation and SGLT2, increased serum ghrelin, and favorable miR expression changes.
LV-DF normalization at follow-up was predicted by tissue miR-126 and serum ghrelin levels.

Conclusions:

Abdominal fat excision in T2DM obese patients reduces inflammation and modulates SIRT1, SGLT2, ghrelin, and miRs.
These changes contribute to left ventricle diastolic function normalization one year post-surgery.
Ghrelin and specific miRs play a role in predicting LV-DF recovery after fat reduction surgery.