dr Librantoro
Faculty of Medicine, University of Indonesia/ Harapan Kita National Cardiovascular Center

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Correlation Between Circulating Leptin Level with Left Ventricle Mass in Normotensive Men Gunawan, Richard Indra; Kosasih, Adrianus; Lilyasari, Oktavia; Librantoro, dr; Joesoef, Andang H; Kaligis, RWM
Jurnal Kardiologi Indonesia VOL. 28 NO. 4 September 2007
Publisher : Indonesian Heart Association

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Abstract

Background. Obesity is one of Cardiovascular risk factor. Obesity caused increase in heart mass due to cellular hypertrophic and metaplastic proses, independently of hemodynamic factors such as blood pressure. There were hyperleptinemia in obesity due to the selective Leptin resistency in central nervous system and peripheral organs. Study with cultured rat cardiomyocyte have shown hypertrophy and hyperplastic effect of Leptin to cardiomyocyte. Some clinical studies have shown correlation between circulating Leptin level with Left Ventricle Mass in hypertensive and insulin resistance men.Objective. This study aimed to elaborate the correlation between circulating Leptin level with Left Ventricle Mass in normotensive men.Methods. A cross sectional study was performed with normotensive men, which included 40 obese normotensive and 40 normoweight men. All patients underwent physical and laboratory assessment and examination of Left Ventricle with echocardiography. The circulating Leptin level were determined by ELISA method. The Leptin level were expressed as median (25th percentile; 75th percentile)Results. The circulating Leptin level were significantly different between the obese normotensive and the lean group. The Left Ventricle Mass in Obese increased, although have not fulfilled the criteria for Left Ventricle Hypertrophy. There were significant correlation between Left Ventricle Mass with BMI (r = 0,711; p<0,001) and waist circumference (r = 0,732; p<0,001). Respectively, there were significant correlation between Left Ventricle Mass Index with BMI (r = 0.541; p<0.001) and waist circumference (r = 0,558; p<0.001. There were significant correlation between circulating Leptin level with Left Ventricle Mass (r = 0,510; <0,001) and Left Ventricle Mass Index (r = 0,414; p<0,001) inobese  men.Conclusion. Circulating Leptin level is correlated with Left Ventricle Mass in normotensive men.
Correlation Between Plasma Leptin and Endotelin-1 Plasma Level in Obese Hypertensive Subjects Librantoro, dr; Rahayoe, Anna Ulfah; Andriantoro, Hananto
Jurnal Kardiologi Indonesia Vol. 28 NO.4 Juli 2007
Publisher : Indonesian Heart Association

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Background. Hypertension is frequently found in obesity, although the mechanisms for obesity related hypertension are still unclear. Several studies showed the role of endothelin-1 in the development of hypertension associated with obesity. More recent studies showed the possibility for the role of leptin in obesity related hypertension. In vitro study with human umbilical vein endothelial cells (HUVECs) showed correlation between leptin and endothelin-1. The aim of this study was to clarify the relationship between leptin, body mass index (BMI), blood pressure (BP) and plasma endothelin-1 in obese hypertensive subjects.Methods. A cross sectional study was performed at National Cardiovascular Centre, Harapan Kita Jakarta, which included 80 Indonesian men. The subjects were divided into lean hypertensive and obese hypertensive. The plasma immunoreactive ET-1 and leptin were determined by ELISA method.Results. ET-1 level and leptin level were significantly higher in obese hypertensive subjects compared with lean hypertensive subjects. There are significant correlation between endothelin level with BMI (r = 0.32; p <0.005). There are also significant correlation between leptin level with BMI (r = 0.533; p <0.01), but there are no correlation between plasma leptin and endothelin-1 level in obese hypertensive men.Conclusions. Leptin and ET-1 level were significantly increase in obese hypertensive subjects compared with lean hypertensive subjects. There is no correlation between leptin and ET-1 level in obese hypertensive subjects
Correlation Between Arterial Stiffness and Plasma Endothelin-1 Concentration in Man with Obesity Kosasih, Adrianus; Lilyasari, Oktavia; Gunawan, Richard Indra; Librantoro, dr; Haryono, Nur; Sunu, Ismoyo
Jurnal Kardiologi Indonesia Vol. 28 NO.4 Juli 2007
Publisher : Indonesian Heart Association

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Abstract

Background. Obesity is associated with increase arterial stiffness and elevated plasma endothelin-1 concentration. However, there is still conflicting data regarding the effect of obesity on arterial stiffness and plasma endothelin-1 concentration.Objective. The purpose of the current study was to assess this effect and analyze whether there was correlation between arterial stiffness indices and plasma endothelin-1 concentration.Methods. The design of the study was cross sectional study that compare and correlate arterial stiffness and plasma endothelin-1 concentration between obesity group (n=40) and normoweight group (n=40). Obesity was defined as body mass index = 25 kg/m2. Arterial stiffness was assessed by measuring carotid-femoral pulse wave velocity (PWV) dan β stiffness index (β) non-invasively using ultrasound method. Endothelin-1 was measured by ELISA.Results. There was no significant difference regarding PWV between obesity and normoweight group (mean ± SD: 809.44 ± 137.77 versus 850.96 ± 211.60 cm/s, p=NS), but β was significantly higher in obese group (8.79 ± 3.15 versus 7.28 ± 1.96, p=0.012). PWV and β correlated significantly with age (PWV: r=0.446, p<0.001, β : r=0.354, p=0.001), but only β correlated with body mass index (r=0.282, p=0.011) and waist circumference (r=0.312, p=0.005). There was no significant difference between obesity and normoweight group regarding plasma endothelin-1 concentration (0.94 ± 0.26 versus 0.95 ± 0.18pg/dl, p=NS). There are no significant  correlations  between PWV/β andplasma endothelin-1 concentration.Conclusions. These findings suggest that the effect of obesity on arterialstiffness is not uniformly seen  throughout all arterial region. Obesity impact on carotid artery is greater than its impact on aorta, and this impact on arterial stiffness is not mediated by endothelin-1.