Plasma des-acyl ghrelin, but not plasma HMW adiponectin, is a useful cardiometabolic marker for predicting atherosclerosis in elderly hypertensive patients

Yano, Yuichiro; Toshinai, Koji; Inokuchi, Takashi; Kangawa, Kenji; Shimada, Kazuyuki; Kario, Kazuomi; Nakazato, Masamitsu

doi:10.1016/j.atherosclerosis.2008.10.013

« Previous Next »Atherosclerosis
Volume 204, Issue 2 , Pages 590-594, June 2009

Plasma des-acyl ghrelin, but not plasma HMW adiponectin, is a useful cardiometabolic marker for predicting atherosclerosis in elderly hypertensive patients

Yuichiro Yano
- Division of Internal Medicine, Nango National Health Insurance Hospital, Japan
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Japan
- Corresponding author at: Division of Internal Medicine, Nango National Health Insurance Hospital, 1078 Mikado, Nango, Misato Town, Miyazaki 883-0306, Japan. Tel.: +81 982 59 0017; fax: +81 982 59 0213.
Koji Toshinai
- Division of Neurology, Respirology, Endocrinology and Metabolism, Department of Internal Medicine, Miyazaki Medical College, University of Miyazaki, Japan
Takashi Inokuchi
- Department of Orthopedic Surgery, Kitaura National Health Insurance Hospital, Japan
Kenji Kangawa
- Department of Biochemistry, National Cardiovascular Center Research Institute, Japan
Kazuyuki Shimada
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Japan
Kazuomi Kario
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Japan
Masamitsu Nakazato
- Division of Neurology, Respirology, Endocrinology and Metabolism, Department of Internal Medicine, Miyazaki Medical College, University of Miyazaki, Japan

Received 9 August 2008; received in revised form 17 September 2008; accepted 12 October 2008. published online 28 November 2008.

Abstract

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.

Results and conclusion

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 (β=−0.178, P=0.001). Moreover, the increased risk of cIMT among those with abdominal obesity compared with non-obesity (0.833±0.185mm vs. 0.782±0.163mm, 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.