A possible role for ghrelin, leptin, brain-derived neurotrophic factor and docosahexaenoic acid in reducing the quality of life of coeliac disease patients following a gluten-free diet

Francesco Russo, Guglielmina Chimienti, Caterina Clemente, Carla Ferreri, Antonella Orlando, Giuseppe Riezzo

Research output: Contribution to journalArticle


PURPOSE: A gluten-free diet (GFD) has been reported to negatively impact the quality of life (QoL) of coeliac disease (CD) patients. The gut-brain axis hormones ghrelin and leptin, with the brain-derived neurotrophic factor (BDNF), may affect QoL of CD patients undergoing GFD. Our aims were to evaluate whether: (a) the circulating concentrations of leptin, ghrelin and BDNF in CD patients were different from those in healthy subjects; (b) GFD might induce changes in their levels; (c) BDNF Val66Met polymorphism variability might affect BDNF levels; and (d) serum BDNF levels were related to dietary docosahexaenoic acid (DHA) as a neurotrophin modulator.

METHODS: Nineteen adult coeliac patients and 21 healthy controls were included. A QoL questionnaire was administered, and serum concentrations of ghrelin, leptin, BDNF and red blood cell membrane DHA levels were determined at the enrolment and after 1 year of GFD. BDNF Val66Met polymorphism was analysed.

RESULTS: Results from the questionnaire indicated a decline in QoL after GFD. Ghrelin and leptin levels were not significantly different between groups. BDNF levels were significantly (p = 0.0213) lower in patients after GFD (22.0 ± 2.4 ng/ml) compared to controls (31.2 ± 2.2 ng/ml) and patients at diagnosis (25.0 ± 2.5 ng/ml). BDNF levels correlated with DHA levels (p = 0.008, r = 0.341) and the questionnaire total score (p = 0.041, r = 0.334).

CONCLUSIONS: Ghrelin and leptin seem to not be associated with changes in QoL of patients undergoing dietetic treatment. In contrast, a link between BDNF reduction and the vulnerability of CD patients to psychological distress could be proposed, with DHA representing a possible intermediate.

Original languageEnglish
Pages (from-to)807-818
Number of pages12
JournalEuropean Journal of Nutrition
Issue number2
Publication statusPublished - Mar 2017



  • Adult
  • Alleles
  • Amino Acid Substitution
  • Brain-Derived Neurotrophic Factor
  • Case-Control Studies
  • Celiac Disease
  • Diarrhea
  • Diet, Gluten-Free
  • Docosahexaenoic Acids
  • Erythrocyte Membrane
  • Female
  • Follow-Up Studies
  • Gene Frequency
  • Genetic Association Studies
  • Ghrelin
  • Heterozygote
  • Humans
  • Italy
  • Leptin
  • Male
  • Polymorphism, Single Nucleotide
  • Prospective Studies
  • Quality of Life
  • Stress, Psychological
  • Journal Article

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