title: Unacylated Ghrelin is associated with the isolated low HDL-cholesterol obese phenotype independently of insulin resistance and CRP level.
abstract: BACKGROUND
  Low plasma high-density lipoprotein-cholesterol (HDL-c) level is commonly present in obesity and represents an independent cardiovascular risk factor. However, obese patients are a very heterogeneous population and the factors and mechanisms that contribute to low HDL-c remain unclear. The aim of this study was to investigate the association between plasma HDL-c levels and plasma hormonal profiles (insulin, adiponectin, resistin, leptin and ghrelin) in subsets of class II and III obese patients.
  
  
  METHODS
  Fasting plasma levels of glucose, total cholesterol, LDL-c, HDL-c, triglycerides, free fatty acids, apoproteins A-I, B-100, B-48, C-II, C-III, insulin, hs-CRP, adipocytokines (adiponectin, resistin, leptin), unacylated ghrelin, body composition (DXA) and resting energy expenditure were measured in three subsets of obese patients: 17 metabolically abnormal obese (MAO) with metabolic syndrome and the typical metabolic dyslipidaemia, 21 metabolically healthy obese (MHO) without metabolic syndrome and with a normal lipid profile, and 21 isolated low HDL-c obese patients (LHO) without metabolic syndrome, compared to 21 healthy lean control subjects.
  
  
  RESULTS
  Insulin resistance (HOMA-IR) increased gradually from MHO to LHO and from LHO to MAO patients (p < 0.05 between MHO and MAO and between LHO and MAO). In multiple regression analysis, serum unacylated ghrelin levels were only positively and independently associated with HDL-c levels in the LHO group (p = 0.032).
  
  
  CONCLUSIONS
  These results suggest that, in class II and III obese patients with an isolated low HDL-c phenotype, unacylated ghrelin is positively associated with HDL-c level independently of insulin resistance and CRP levels, and may contribute to the highly prevalent low HDL-c level seen in obesity.
authors.affiliation: Aix-Marseille Univ, UMR 1260, 13005 Marseille, France. RVALERO@mail.ap-hm.fr.
authors.forename: Juan-Patricio
authors.initials: JP
authors.lastname: Nogueira
authors.forename: Marie
authors.initials: M
authors.lastname: Maraninchi
authors.forename: Sophie
authors.initials: S
authors.lastname: Béliard
authors.forename: Anne Marie
authors.initials: AM
authors.lastname: Lorec
authors.forename: Bruno
authors.initials: B
authors.lastname: Berthet
authors.forename: Audrey
authors.initials: A
authors.lastname: Bégu-Le Corroller
authors.forename: Noémie
authors.initials: N
authors.lastname: Dubois
authors.forename: Rachel
authors.initials: R
authors.lastname: Grangeot
authors.forename: Catherine
authors.initials: C
authors.lastname: Mattei
authors.forename: Jean
authors.initials: J
authors.lastname: Gaudart
authors.forename: Alain
authors.initials: A
authors.lastname: Nicolay
authors.forename: Henri
authors.initials: H
authors.lastname: Portugal
authors.forename: Bernard
authors.initials: B
authors.lastname: Vialettes
authors.forename: René
authors.initials: R
authors.lastname: Valéro