However, ghrelin in pathophysiologic concentrations, as seen in patients with anorexia nervosa, Prader-Willi syndrome, and type 2 diabetes, increases endothelial cell adhesion molecule (intercellular adhesion molecule-1, ICAM-1; vascular cell adhesion molecule-1,VCAM-1) expression, possibly contributing to increased atherosclerosis risk in such subjects [58]. This evidence concerns the gene VCAM1 and atherosclerosis.