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. 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 (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. (C) 2008 Elsevier Ireland Ltd. All rights reserved.