Correlation of Tumor Necrosis Factor with Left Ventricular Hypertrophy and Prehypertension in Non Diabetes Male Abdominal Obesity

  • Frans Wantania Fakultas Kedokteran Universitas Samratulangi, Manado.
  • Lucia Panda Fakultas Kedokteran Universitas Samratulangi, Manado.
  • Reggy L. Lefrandt Fakultas Kedokteran Universitas Samratulangi, Manado.
Keywords: TNF ?, LVH, Prehypertension, Abdominal obesity


Introduction : Left Ventricular Hypertrophy (LVH) as an independentpredictor of mortality may develop in non diabetes obese. Theres a roleof inflammation because adipose tissue release the proinflammatory cytokinessuch as TNF ?. It is important to prove this inflammatory state andits impact to the healthy obese for preventing cardiovascular events in thefuture. Purpose of this study is to investigate correlation of TNF ? levelwith LVH and Prehypertension in non diabetes abdominal obesity.Methods : Eighty-two male abdominal obesity and non abdominal obesitysubjects with no history of diabetes were recruited in this cross-sectionalstudy. Tumor Necrosis Factor Alpha level were measured with radioimmunoassay,blood pressure measurement was taken 2 times. Left VentricularMass Index(LVMI) were evaluated by M-Mode and two dimensionechocardiogram and value above 115 g/m2 are indicative of LVH.Result : TNFa alpha level is higher in abdominal obesity group as compareto non abdominal obesity (0,7133+0,2072 pg/ml vs 2,395+1,5371 pg/ml,p<0,001). Most of obese subjects developed prehypertension. Subjectswith prehypertension showed higher plasma TNF alpha level as compare tosubject with normal blood pressure (2,83+1,649 pg/ml vs 1,38 + 0,3245pg/ml, p<0,001). We also found the LVH in 30 (60%) of abdominal obesitysubjects. Obese subject had larger LVMI than non obese (138,427+47,461g/m2 vs 90,188+16,06 g/m2, p<0,001), and correlates positively to plasmaTNF alpha level (r=0,727, p,<0,001).Conclusion : High level of plasma TNF alpha is associated with left ventricularhypertrophy and prehypertension in non diabetes male abdominalobesity.


Download data is not yet available.

Author Biographies

Frans Wantania, Fakultas Kedokteran Universitas Samratulangi, Manado.
Departemen Kardiologi dan Kedokteran Vaskular
Lucia Panda, Fakultas Kedokteran Universitas Samratulangi, Manado.
Departemen Kardiologi dan Kedokteran Vaskular
Reggy L. Lefrandt, Fakultas Kedokteran Universitas Samratulangi, Manado.
Departemen Kardiologi dan Kedokteran Vaskular


Anderson PM, Butcher KE. Childhood obesity: trends and

potential causes. Future Child 2006: 16:19-45

Sorof J, Daniels S. Obesity hypertension in children: a problem

of epidemic proportions. Hypertension 2002; 40:441-7

Kenchaiah S, Evans JC, Levy D, et al. Obesity and the risk of

heart faFilure. N Engl J Med 2002; 347:305-13

Alpert MA. Obesity cardiomyopathy: pathophysiology and

evolution of the clinical syndrome. Am J Med Sci 2001;


Hajer GR, Haeften TW, and Visseren FLJ. Adipose tissue dysfunction

in obesity, diabetes, and vascular diseases. Eur Heart

Journal 2008; 29:2959-7

Kuwahara F, Kai H, Tokuda K, Nilyama H, Tahara N, Kusaba K,

et al. Roles of intercellular adhesion molecule-1 in hypertensive

cardiac remodelling. Hypertension 2003; 41:819-23

Kuwahara K, Kai H, Tokuda K, Kai M, Takeshita A, Egashira

K, et al. Transforming growth factor beta function blocking

prevents myocardial fibrosis and diastolic dysfunction in

pressure-overloaded rats. Circulation 2002; 106:130-5

Erten Y, Tulmac M, Derici U, Pasaoglu H, Altok RK, Bali M,

et al. An association between inflammatory state and left ventricular

hypertrophy in hemodialysis patients. Ren Fall 2005;


Executive summary of the third report of the National Cholesterol

Education Program (NCEP) Adult Treatment Panel III.

JAMA 2001; 285:2486-97

Khouri MG, Peshock RM, Ayers CR, James AL, and Drazner

MH. A 4-tiered classification of left ventricular hypertrophy

based on left ventricular geometry. Circ Cardiovasc Imaging

; 3:164-71

Hopkins TA, Ouchi N, Shibata R, Waish K. Adiponectin actions

in the cardiovascular system. Cardiovasc Res 2007;74:11-8

Wellen KE and Hotamisligil GS. Obesity-induced inflammatory

changes in adipose tissue. J Clin Invest 2003; 112:1785-8

Hotamisligil GS, Arner P, Caro JF, Atkinson RL, Spiegelman

BM. Increased adipose tissue expression of tumor necrosis factor-alpha in human obesity and insulin resistance. J Clin

Invest 1995; 95:2409-15

Kern PA, Saghizadeh M, Ong JM, Bosch RJ, Deem R, Simsolo

RB. The expression of tumor necrosis factor in human adipose

tissue. Regulation by obesity, weight loss, and relationship to

lipoprotein lipase. J Clin Invest 1995; 95:2111-9

Zahorska B, Janowska J, Olszanecka M, and Zurakowski A.

Serum concentrations of TNF-alpha and soluble TNF-alpha

receptors in obesity. International Journal of Obesity 2000;


Chrysohoou C, Pitsavos C, Panagiotakos DB, Skoumas J,

Stefanadis C. Association between prehypertension status and

inflammatory markers related to atherosclerotic disease: The

ATTICA Study. Am J Hypertens 2004; 17: 568-73

Bullo M, Garcia-Lorda P, Megias I, Salas-Salvado J. Systemic

inflammation, adipose tissue tumor necrosis factor, and leptin

expression. Obes Res 2003; 11: 525-31.

Lee YH, Pratley RE. The evolving role of inflammation in

obesityand the metabolic syndrome. Curr Diab Rep 2005; 5:


Zhang C, Xu X, Wang W, Michael L, Kuo L, and Chilian WM.

TNF-alpha contributes to endothelial dysfunction in ischmia/

reperfusion injury. Arterioscler Thromb Vasc Biol 2006; 26:475-

Zhang DX, Yi FX, Zou AP, Li PL. Role of ceramide in TNFalpha

induced impairment of endothelium-dependent vasorelaxation

in coronary arteries. Am J Physiol Heart Circ Physiol

; 282:1785-94

Picchi A, Gao X, Belmadani S, Potter BJ, Foccardi M, Chilian

WM, et al. Tumor necrosis factor-alpha induces endothelial

dysfunction in the prediabetic metabolic syndrome. Circ Res

; 99:69-77

Palmieri V, de Simone G, Arnett DK, et al. Relation of various

degrees of body mass index in patients with systemic hypertension

to left ventricular mass, cardiac output, and peripheral

resistance. Am J Cardiol 2001; 88:1163-8

Baumgarten G, Knuefermann P, Mann DL. Cytokines as emerging

targets in the treatment of heart failure. Trends Cardiovasc

Med 2000; 10:216-23

Gorzelniak K, Engeli S, Janke J, Luft FC, Sharma AM. Hormonal

regulation of the human adipose-tissue renin-angiotensin

system: relationship to obesity and hypertension. J Hypertens

; 20:965-73

Zhou YT, Grayburn P, Karim A, et al. Lipotoxic heart disease

in obese rats: implication for human obesity. Proc Natl Acad

Sci USA 2000; 97:1784-9

Isakson P, Hammarstedt A,.. Impaired preadipocyte differentiation

in human abdominal obesity. Diabetes 2009

Jobe LJ, Melendez GC, Levick SP, Du Y, Brower GL, and Janicki

JS. TNF-alpha inhibition attenuates adverse myocardial

remodeling in a rat model of volume overload. Am J Physiol

Heart Circ Physiol 2009; 297:462-8

Yokoyama T, Nakano M, Bednarczyk JL, et al. Tumor necrosis

factor-alpha provokes a hypertrophic growth response in adult

cardiac myocytes. Circulation 1997; 95:1247-52

Higuchi Y, Otsu K, Nishida K, Hirotani S, Nakayama H, Yamaguchi

O, Matsumura Y, Ueno H, Tada M, Hori M. Involvement

of reactive oxygen species-mediated NF-kappa B activation in

TNF-alpha-induced cardiomyocyte hypertrophy. J Mol Cell

Cardiol. 2002; 34:233–240. [PubMed: 11851362]

Higuchi Y, McTiernan CF, Frye CB, McGowan BS, Chan TO,

Feldman AM. Tumor necrosis factor receptors 1 and 2 differentially

regulate survival, cardiac dysfunction, and remodeling

in transgenic mice with tumor necrosis factor-alpha-induced

cardiomyopathy. Circulation. 2004; 109:1892–1897. [PubMed:


Abstract viewed :
33 times
PDF downloaded : 38 times

How to Cite
Wantania, F., Panda, L., & Lefrandt, R. (2015). Correlation of Tumor Necrosis Factor with Left Ventricular Hypertrophy and Prehypertension in Non Diabetes Male Abdominal Obesity. Indonesian Journal of Cardiology, 34(4), 231-6.
Clinical Research