Plasma des-acyl ghrelin, but not plasma HMW adiponectin, is a useful cardiometabolic marker for predicting atherosclerosis in elderly hypertensive patients.
OBJECTIVE
The coming obesity epidemic in elderly persons necessitates the establishment of new and easy-to-use cardiometabolic markers to identify individuals most likely to develop atherosclerosis among hypertensives.


METHODS
We measured plasma HMW adiponectin and des-acyl ghrelin levels, and carotid-artery intima-media thickness (cIMT) in 263 elderly hypertensives (mean 72.6 years; 37%men). Other cardiometabolic markers, including metabolites, inflammation, and hemostasis, were also measured.


CONCLUSIONS
Both HMW adiponectin and des-acyl ghrelin levels were inversely correlated with obesity. The HMW adiponectin level was favorably associated with glucose and lipid metabolites, PAI-1 (all P<0.05), and hs-CRP (P=0.07) after adjustment for age, sex, and BMI; however, it had no correlations with cIMT. In contrast, although there were no correlations between des-acyl ghrelin and cardiometabolic markers, except for a positive association with the nitrite/nitrate (NO(x)) level (P=0.002), des-acyl ghrelin had a significant inverse correlation with cIMT (P=0.003). A multivariable regression analysis showed that des-acyl ghrelin, but not HMW adiponectin, was significantly associated with cIMT after adjusting for age, obesity, sex, smoking, 24-h BP, and other cardiometabolic factors (beta=-0.178, P=0.001). Moreover, the increased risk of cIMT among those with abdominal obesity compared with non-obesity (0.833+/-0.185 mm vs. 0.782+/-0.163 mm, P=0.019) was explained by the elevated 24-h BP and reduced des-acyl ghrelin level, but not by other cardiometabolic parameters. These associations were unchanged after adding NO(x) to the model. In conclusion, the des-acyl ghrelin level is a useful cardiometabolic marker for predicting atherosclerosis in elderly hypertensives, and the pathologic pathway linking these factors is independent of its NO bioactivity.
Yano
Yuichiro
Y
Division of Internal Medicine, Nango National Health Insurance Hospital, Nango, Miyazaki, Japan. yyano@jichi.jp
Toshinai
Koji
K
Inokuchi
Takashi
T
Kangawa
Kenji
K
Shimada
Kazuyuki
K
Kario
Kazuomi
K
Nakazato
Masamitsu
M
D052242:Adiponectin / Q000097:blood; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000032:analysis; D002097:C-Reactive Protein / Q000032:analysis; D002340:Carotid Artery Diseases / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology*; D003430:Cross-Sectional Studies; D005260:Female; D054439:Ghrelin / Q000097:blood*; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000150:complications* / Q000000981:diagnostic imaging; D018836:Inflammation Mediators / Q000097:blood; D007328:Insulin / Q000097:blood; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D008970:Molecular Weight; D009566:Nitrates / Q000097:blood; D009573:Nitrites / Q000097:blood; D009765:Obesity / Q000097:blood / Q000150:complications* / Q000000981:diagnostic imaging; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood; D011237:Predictive Value of Tests; D012044:Regression Analysis; D018570:Risk Assessment; D012307:Risk Factors; D014463:Ultrasonography
C499918:ADIPOQ protein, human; D052242:Adiponectin; D015415:Biomarkers; D001786:Blood Glucose; C515349:GHRL protein, human; D054439:Ghrelin; D018836:Inflammation Mediators; D007328:Insulin; D008055:Lipids; D009566:Nitrates; D009573:Nitrites; D017395:Plasminogen Activator Inhibitor 1; C051321:SERPINE1 protein, human; C422650:ghrelin, des-n-octanoyl; D002097:C-Reactive Protein