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Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.  Labels: OBJECTIVE, METHODS. Meshes: Adiponectin, Age Factors, Aged, Aged, 80 and over, Biomarkers, Blood Glucose, C-Reactive Protein, Carotid Artery Diseases, Cross-Sectional Studies, Female, Ghrelin, Humans, Hypertension, Inflammation Mediators, Insulin, Lipids, Male, Middle Aged, Molecular Weight, Nitrates, Nitrites, Obesity, Plasminogen Activator Inhibitor 1, Predictive Value of Tests, Regression Analysis, Risk Assessment, Risk Factors, Ultrasonography.
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Is plasma des-acyl ghrelin , but not plasma HMW adiponectin , a useful cardiometabolic marker for predicting atherosclerosis in elderly hypertensive patients? Context: 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. 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.
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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. Final Decision: yes