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


Introduction : Left Ventricular Hypertrophy (LVH) as an independent
predictor of mortality may develop in non diabetes obese. There’s a role
of inflammation because adipose tissue release the proinflammatory cytokines
such as TNF ?. It is important to prove this inflammatory state and
its impact to the healthy obese for preventing cardiovascular events in the
future. Purpose of this study is to investigate correlation of TNF ? level
with LVH and Prehypertension in non diabetes abdominal obesity.
Methods : Eighty-two male abdominal obesity and non abdominal obesity
subjects with no history of diabetes were recruited in this cross-sectional
study. Tumor Necrosis Factor Alpha level were measured with radioimmunoassay,
blood pressure measurement was taken 2 times. Left Ventricular
Mass Index(LVMI) were evaluated by M-Mode and two dimension
echocardiogram and value above 115 g/m2 are indicative of LVH.
Result : TNFa alpha level is higher in abdominal obesity group as compare
to 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. Subjects
with prehypertension showed higher plasma TNF alpha level as compare to
subject with normal blood pressure (2,83+1,649 pg/ml vs 1,38 + 0,3245
pg/ml, p<0,001). We also found the LVH in 30 (60%) of abdominal obesity
subjects. Obese subject had larger LVMI than non obese (138,427+47,461
g/m2 vs 90,188+16,06 g/m2, p<0,001), and correlates positively to plasma
TNF alpha level (r=0,727, p,<0,001).
Conclusion : High level of plasma TNF alpha is associated with left ventricular
hypertrophy and prehypertension in non diabetes male abdominal


Download data is not yet available.


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
2010; 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
2002; 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
2006; 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
2002; 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:
Views & Downloads
Abstract views: 135   
PDF downloads: 72   
How to Cite
Correlation of Tumor Necrosis Factor with Left Ventricular Hypertrophy and Prehypertension in Non Diabetes Male Abdominal Obesity. (2015). Indonesian Journal of Cardiology, 34(4), 231-6.
Clinical Research