Ghrelin is the only known orexigenic gut hormone, and its synthesis, secretion and degradation are affected by different metabolic statuses. This meta-analysis aimed to investigate the potential differences in plasma acyl ghrelin (AG) and des-acyl ghrelin (DAG) concentrations between normal weight and obese adults. Systematic literature searches of PubMed, Embase and Web of Science through October 2021 were conducted for articles reporting AG or DAG levels in obesity and normal weight, and 34 studies with 1863 participants who met the eligibility criteria were identified. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated to evaluate group differences in circulating AG and DAG levels. Pooled effect size showed significantly lower levels of baseline AG (SMD: − 0.85; 95% CI: − 1.13 to − 0.57; PSMD < 0.001) and DAG (SMD: − 1.06; 95% CI: − 1.43 to − 0.69; PSMD < 0.001) in obese groups compared with healthy controls, and similar results were observed when subgroup analyses were stratified by the assay technique or storage procedure. Postprandial AG levels in obese subjects were significantly lower than those in controls when stratified by different time points (SMD 30 min: − 0.85, 95% CI: − 1.18 to − 0.53, PSMD < 0.001; SMD 60 min: − 1.00, 95% CI: − 1.37 to − 0.63, PSMD < 0.001; SMD 120 min: − 1.21, 95% CI: − 1.59 to − 0.83, PSMD < 0.001). In healthy subjects, a postprandial decline in AG was observed at 120 min (SMD: − 0.42; 95% CI: − 0.77 to − 0.06; PSMD = 0.021) but not in obese subjects (SMD: − 0.28; 95% CI: − 0.60 to 0.03; PSMD = 0.074). The mean change in AG concentration was similar in both the obese and lean health groups at each time point (ΔSMD30min: 0.31, 95% CI: − 0.35 to 0.97, PSMD = 0.359; ΔSMD60min: 0.17, 95% CI: − 0.12 to 0.46, PSMD = 0.246; ΔSMD120min: 0.21, 95% CI: − 0.13 to 0.54, PSMD = 0.224). This meta-analysis strengthens the clinical evidence supporting the following: lower baseline levels of circulating AG and DAG in obese individuals; declines in postprandial circulating AG levels, both for the healthy and obese individuals; a shorter duration of AG suppression in obese subjects after meal intake. These conclusions have significance for follow-up studies to elucidate the role of various ghrelin forms in energy homeostasis.
Background: While hyperuricaemia and overweight/obesity can act alone to increase the prevalence of hypertension, few studies have examined their combined effect. Methods: This cross-sectional study of 42 332 Han Chinese from southwestern China investigated the combined effect of hyperuricaemia and overweight/obesity on risk of hypertension in the entire sample as well as in different genders and age groups. Results: Hypertension was significantly more prevalent among individuals with both hyperuricaemia and overweight/obesity (45.5%) than among those with hyperuricaemia alone (28.1%) or overweight/obesity alone (31.3%). Similarly, the increase in hypertension risk in the presence of both hyperuricaemia and overweight/obesity (OR = 6.777, 95%CI 6.133, 7.489) was significantly greater than the increase in the presence of hyperuricaemia alone (OR = 3.168, 95%CI 2.705, 3.711) or overweight/obesity alone (OR = 3.693, 95% CI 3.503, 3.893). These results were similar across each age group. The same trend was also observed when comparing men and women, though the odds ratios were greater for women. Conclusion: Co-occurrence of hyperuricaemia and overweight/obesity increases risk of hypertension more than either morbidity on its own, and this risk differential is significantly greater in women than men. These findings should be confirmed in other ethnic groups and in longitudinal studies.
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