Abstract
OBJECTIVE: Sleep disturbance is a commonly observed issue in individuals diagnosed with alcohol dependence (AD). Ghrelin, a peptide known for its role in stimulating appetite and maintaining energy balance, also plays a crucial role in regulating higher brain functions, such as the sleep-wake cycle. Existing evidence indicates a decrease in peripheral ghrelin levels among individuals with AD. However, there is a lack of research examining the correlation between circulating ghrelin levels and sleep quality in individuals with AD. METHODS: A cohort consisting of 114 patients diagnosed with AD and 73 healthy controls were included. The patients with AD underwent a one-month rehabilitation treatment program, following which both groups underwent assessments of sleep quality and serum ghrelin levels. Objective measures of sleep quality were evaluated using the cardiopulmonary coupling method. Serum ghrelin levels were quantified using the multiplex luminex assay. The study conducted a comparison of serum ghrelin levels between AD group and control group, as well as an evaluation of the correlation between ghrelin levels and sleep quality in AD patients using Spearman correlation analysis. Additionally, the study compared serum ghrelin levels between AD patients with and without obstructive sleep apnea (OSA), and assessed the discriminative capacity of ghrelin in predicting the presence of OSA in AD patients using the receiver operating characteristic (ROC) curve method. RESULTS: The serum ghrelin levels were significantly lower in the AD group compared to the control group (P < 0.001). Moreover, there was a negative correlation between serum ghrelin concentrations and the apnea-hypopnea index (AHI) (P = 0.011) in patients with AD. Furthermore, AD patients with OSA had lower levels of ghrelin compared to AD patients without OSA (P = 0.037). Additionally, ROC curve analysis demonstrated that serum ghrelin had high accuracy in distinguishing AD patients with OSA from AD patients without OSA (AUC = 0.742, P = 0.037). CONCLUSION: These findings offer direct evidence, potentially establishing for the first time, that alterations in peripheral ghrelin levels could be linked to AHI in individuals following abstinence and show considerable potential as biomarkers for distinguishing AD patients with OSA from those without OSA.