Serum ghrelin level and TNF-α/ghrelin ratio in patients with previous myocardial infarction.
OBJECTIVE
Studies investigating serum ghrelin level in atherosclerosis yielded contradictory results. Interaction of ghrelin with adipocytokines is obscure in cardiovascular diseases. We undertook this study to determine which molecules influence ghrelin level and to see whether post-myocardial infarction (MI) patients have decreased ghrelin levels.


METHODS
In this cross-sectional study, acyl-ghrelin concentration was determined by radioimmunoassay in sera of 171 patients (ages 62 ± 6 years, mean ± SD) with previous MI and 81 age-matched referent subjects. We evaluated the associations of ghrelin with insulin, adiponectin, leptin, resistin, fetuin-A and tumor necrosis factor-alpha (TNF-α).


RESULTS
Patients had lower ghrelin levels compared to referent subjects (240.55 ± 59.33 vs. 337.96 ± 30.75 pg/mL, p <0.001) even after excluding diabetic and obese patients (240.63 ± 54.08 vs. 337.96 ± 30.75, p <0.001). In multivariate analysis, insulin (β = -0.327, p <0.001) and adiponectin (β = 0.301, p <0.001) determined ghrelin level (R(2) = 0.199, p <0.001). There was no association between ghrelin and TNF-α levels. In discriminant analysis using ghrelin, adiponectin, leptin, fetuin-A, resistin and TNF-α, the structure matrix revealed ghrelin and TNF-α as strongest predictors for belonging to the patient group (0.760 and -0.569, respectively). Using these two parameters, 89.7% of cases were correctly classified. Subjects with high TNF-α/ghrelin ratio had 11.25 times higher chance for belonging to the patient group (95% CI 5.80-21.80; χ(2) (1) = 215.6, p <0.001)


CONCLUSIONS
Acylated ghrelin levels are decreased in patients with coronary atherosclerosis, independently of body weight and the presence of type 2 diabetes mellitus. Ghrelin level is determined by elevated insulin and decreased adiponectin levels. Ghrelin alone or in combination with TNF-α may prove to be a novel indicator of coronary atherosclerosis.
Department of Family Medicine, Semmelweis University, Budapest, Hungary. voros@csot.sote.hu
Krisztián
K
Vörös
Zoltán
Z
Prohászka
Edit
E
Kaszás
Anna
A
Alliquander
András
A
Terebesy
Ferenc
F
Horváth
Leonard
L
Janik
Agnes
A
Sima
Judit
J
Forrai
Károly
K
Cseh
László
L
Kalabay
D052242:Adiponectin / Q000097:blood; D000368:Aged; D050197:Atherosclerosis / Q000097:blood / Q000150:complications; D001786:Blood Glucose / Q000032:analysis; D001835:Body Weight; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications; D005260:Female; D054439:Ghrelin / Q000097:blood*; D006801:Humans; D007328:Insulin / Q000097:blood; D020738:Leptin / Q000097:blood; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood*; D052243:Resistin / Q000097:blood; D014409:Tumor Necrosis Factor-alpha / Q000097:blood*; D060749:alpha-2-HS-Glycoprotein / Q000032:analysis
D052242:Adiponectin; D001786:Blood Glucose; D054439:Ghrelin; D007328:Insulin; D020738:Leptin; D052243:Resistin; D014409:Tumor Necrosis Factor-alpha; D060749:alpha-2-HS-Glycoprotein