Elevated ghrelin levels in the peritoneal fluid of patients with endometriosis: associations with vascular endothelial growth factor (VEGF) and inflammatory cytokines

ObjectiveTo study ghrelin concentrations in the peritoneal fluid of women with endometriosis and of control women without pelvic pathology and its associations with the levels of proinflammatory cytokines and vascular endothelial growth factor (VEGF).DesignCase-control study.SettingUniversity research institution and hospital.Patient(s)Forty-six nonobese women with laparoscopically and histopathologically confirmed endometriosis and 20 control women without pelvic pathology.Intervention(s)Peritoneal fluid was aspirated during routine diagnostic laparoscopic examination.Main Outcome Measure(s)Concentrations of ghrelin and inflammatory cytokines (interleukin [IL]-1β, IL-6, tumor necrosis factor [TNF], and VEGF) in the peritoneal fluid were evaluated by specific enzyme immunoassay and enzyme-linked immunosorbent assays, respectively.Result(s)Ghrelin concentrations in the peritoneal fluid of women with endometriosis were significantly increased as compared with control subjects. Peritoneal ghrelin levels in patients with endometriosis were strongly positively associated with VEGF (rs = 0.625). There was no correlation between ghrelin and IL-1β, IL-6, or TNF.Conclusion(s)The results of the present study show that endometriosis is associated with increased peritoneal ghrelin levels. The association between ghrelin and endometriotic lesion vascularization remains to be elucidated.