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Relations Between Atherogenic Index of Plasma, Ratio of Small Dense Low Density Lipoprotein/Lecithin Cholesterol Acyl Transferase and Ratio of Small Dense Low Density Lipoprotein/Cholesteryl Ester Transfer Protein of Controlled and Uncontrolled Type 2 DM Ellis Susanti; Marsetio Donosepoetro; Gatot Susilo Lawrence
The Indonesian Biomedical Journal Vol 1, No 2 (2009)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v1i2.92

BACKGROUND: Patients with Diabetes Melitus are proven to be prone to atherosclerosis and coronary heart disease, especially type 2 Diabetes Melitus (T2DM) patient who have higher risk and mortality for cardiovascular risk factor. The Dyslipidemia condition is very common in T2DM as one of the risk factors. Diabetic dyslipidemia is marked by the increased triglyceride (TG), low HDL cholesterol (HDL-C), and increased small dense LDL and apolipoprotein B. Therefore the aim of this study is to assess the differential and correlation between Atherogenic Index of Plasma (AIP), ratio of small dense low density lipoprotein (sdLDL)/lecithin cholesterol acyl transferase (LCAT) and ratio of sdLDL/cholesteryl ester transfer protein (CETP) of controlled and uncontrolled T2DM.METHODS: This study was observational with cross sectional design. In total of 72 patients with T2DM consist of 36 controlled and 36 uncontrolled, participated in this study. The serum TG, HDL-C, sdLDL, LCAT and CETP were examined in their relationship with to T2DM risk.RESULTS: The results of the study indicate that the AIP (p<0.001) increase controlled and uncontrolled T2DM and the ratio of sdLDL/CETP (p=0.004), odds ratio of AIP was 4 (95% CI : 1.501-10.658) and odds ratio of sdLDL/CETP ratio was 4 (95% CI : 1.501-10.658) in uncontrolled T2DM.CONCLUSION: This study showed that the AIP and ratio of small dense LDL/CETP had a significant correlation with the uncontrolled T2DM. The AIP and ratio of small dense LDL/CETP increase was found at the uncontrolled T2DM to be 4 times greater than the controlled T2DM.KEYWORDS: T2DM, atherosclerosis, atherogenic index of plasma, small dense LDL, LCAT, CETP, ratio of sdLDL/LCAT, ratio of sdLDL/CETP

Metabolic Syndrome (MetS) and Nonalcoholic Steatohepatitis (NASH): Study of biochemical markers Free Fatty Acid (FFA), Total Antioxidant Status (TAOS), Adiponectin, Transforming Growth Factor (TGF-beta1), in occurence of NASH Agus Sulaeman; A Rifai Amiruddin; Gatot Susilo Lawrence
The Indonesian Biomedical Journal Vol 1, No 1 (2009)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v1i1.81

BACKGROUND: The prevalence of metabolic syndrome (MetS) in USA and Makassar are 22% and 23.7%. The prevalence of Non Alcoholic Steatosis Hepatosis (NASH) in MetS has not been reported. Study in Non-alcoholic Fatty Liver Disease (NAFLD) is 25–90 % in obesity patients. In NASH, there is accumulation of lipid in hepatocyte (raised free fatty acid level), raised stress oxidative (decreased total antioxidant status), raised of inflammation process (decreased adiponectin) and hepatic fibrotic process (raised TGF β1). The aim of this study is to investigate the correlation of free fatty acid, total antioxidant status, adiponectin and TGF-β1 with the occurrence of NASH.METHODS: This was a case control study in man aged ≥30 years old. Metabolic syndrome (MetS) was defined by IDF categories. NASH was defined as fatty liver plus raised type IV collagen level ≥140 ng/ml and Alanine Transferase (ALT) level 1.5x upper normal limit.RESULT: The samples consisted of 8 MetS subjects, 11 MetS subjects with fatty liver and 2 MetS subjects with suspect NASH. Low level of adiponectin and high level free fatty acid led to progression from Fatty Liver (FL) to NASH. Level of total antioxidant and Level of TGF-β1 were relatively steady in NASH.CONCLUSION: The level of Free Fatty acid in subjects with MetS-FL was higher than in subjects with MetS, but was lower than in subjects with MetS-NASH. No difference in total antioxidants status level was observed among all groups. Level of adiponectin decreased in subjects with MetS-FL and MetS-NASH compared with subjects with MetS only. The level of TGF-β1 increased in subjects with MetS-FL more than in subjects with MetS only, and was steady low in subjects with MetS-NASH.KEYWORDS: metabolic syndrome, NASH, free fatty acid, total antioxidant status, adiponectin, transforming growth factor β1

Fibroblast Growth Factor 21 (FGF21), Free Fatty Acid (FFA), High Sensitivity C-reactive Protein (hsCRP) and Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) Among Indonesian Obese Non-Diabetic Males Yani Lina; Gatot Susilo Lawrence; Andi Wijaya; Suryani As'ad
The Indonesian Biomedical Journal Vol 1, No 3 (2009)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v1i3.103

BACKGROUND: Fibroblast growth factor-21 (FGF21) is known as an important endocrine and paracrine regulator of metabolic homeostasis. Recent studies have shown that FGF21 attenuates lipolysis in human adipocytes, which is suggested as a FGF21's mechanism as anti-hyperlipidemia, anti-hyperglycemia and anti-obesity. The aim of this study was to measure the correlation between FGF21, FFA, hsCRP and HOMA-IR among Indonesian obese non diabetic males.METHOD: The study was observational with cross sectional design. The analysis was done in 137 subjects aged 30-60 years with non diabetic abdominal obesity. We measured the biochemical markers FGF21, FFA, hsCRP, fasting insulin and fasting glucose. We also measured weight, height, waist circumrefence (WC), creatinine, serum glutamin oxaloacetic transaminase (SGOT), and serum glutamic pyruvic transaminase (SGPT), systolic blood pressure (SBP) and diastolic blood pressure (DBP). Correlation between markers was measured using Pearson and Spearman's analysis. RESULT: There were significant positive correlations between FGF21-HOMA-IR (r=0.314, p=0.000); FGF21-WC (r=0.173, p=0.043); FFA=hsCRP (r=0.270, p=0.001); and WC-HOMA-IR (r=0.279, p=0.001). There was significant negative correlation between FGF21-FFA (r=-0.038, p=0.657) and FGF21-hsCRP (r=-0.061, p=0.482). CONCLUSION: In this study we found that although there was no significant correlation, FGF21 might act as an anti-lipolytic and anti-inflammation agent among Indonesian obese non-diabetic males. Our findings agree with results of previous studies that the positive correlation between FGF21-WC and FGF21-HOMA-IR moght occur as a compensatory mechanism or resistance to FGF21 in obesity.KEYWORDS: Obesity, FGF21, FFA, hsCRP, HOMA-IR

Visfatin and Adiponectin Have an Opposite Correlation with Inflammation and Metabolic Syndrome in Non-Diabetic Obese Indonesian Men Anna Meiliana; Gatot Susilo Lawrence; Ilhamjaya Patellongi; Andi Wijaya; Suryani As'ad
The Indonesian Biomedical Journal Vol 1, No 3 (2009)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v1i3.104

BACKGROUND: Along with the increase in obesity is a parallel increase in the prevalence of metabolic complications of obesity, often referred to as the metabolic syndrome (MetS). The role of adipose tissue in MetS has continued to evolve with the description of numerous secretory peptides from adipocytes named adipocytokines or adipokines. Recent studies have found visfatin as the regulation of inflammatory and immunomodulating prosesses, meanwhile adiponectin was known to have a potent anti-inflammatory properties. Here we try to assess the correlation between those two adipokines to MetS, via an inflammatory pathway.METHODS: This was a cross-sectional study on 128 non diabetic obese male subject (waist circumferences ≥90 cm). Visfatin and adiponectin were assessed by ELISA. Statistical analysis was performed using SPSS for Windows v.16.00 with signifcantly p<0.05. The correlations among biomarkers were assessed using Spearman's Rho test.RESULTS: This study showed a significant positive correlation between levels of visfatin and inflammatory markers TNF-α (r=0.22, p<0.005), and hsCRP (r=0.12, p=0.19), significant negative correlation between levels of adiponectin and TNF-α (r=-0.22-8, p<0.005-1), adiponectin and hsCRP (r=-0.14, p=0.11) and visfatin (r=-0.029, p<0.01). Plasma visfatin levels were increased along with the number MetS components, white plasma adiponectin showed inversely relation.CONCLUSION: Our present study has shown that visfatin has a proinflammatory properties and adiponectin has an anti-inflammatory properties, and how they have an opposite effects on MetS. Visfatin was found to have a positive correlaton while adiponectin was found to have a negative correlation with the number of MetS components.KEYWORDS: Obesity, Inflammation, Metabolic Syndrome, Adipocytokines, Visfatin, Adiponectin, TNF-α, hsCRP

Role of Postmortem Multislice Computed Tomography Scan in Close Blunt Head Injury Prijo Sidipratomo; Trijono Karmawan Sukana Prija; Bachtiar Murtala; Agus Purwadianto; Gatot Susilo Lawrence
The Indonesian Biomedical Journal Vol 6, No 2 (2014)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v6i2.36

BACKGROUND: Conventional autopsy in Indonesia is not well accepted as it is contrary to religion and culture. New radiological imaging method such as multislice computed tomography (MSCT) scan has potential to be a diagnostic tool in forensic pathology. The purpose of this study is to determine the ability of MSCT scan in finding abnormalities in close blunt head injury compared with autopsy.METHODS: This study used descriptive qualitative method. Postmortem cases in Department of Forensic Medicine and Radiology of Dr. Cipto Mangunkusumo Hospital were selected based on inclusion criteria. Then MSCT scan and autopsy were conducted. MSCT scan and autopsy results were compared and analyzed.RESULTS: There were 491 postmortem cases of blunt head injury. However, only 10 cases fulfilled inclusion criteria. Subarachnoid haemorrhages were identified 100% with MSCT scan and 80% with autopsy. Cerebral oedemas were identified 100% either with MSCT scan and autopsy. Subdural haemorrhages were identified 100% with MSCT scan, while 50% with autopsy. Multiple fractures were identified 80% with MSCT scan, while 40% with auto.CONCLUSION: MSCT scan showed a sensitive detection in finding abnormalities in close blunt head injury. Therefore it could be as an alternative choice of examination in close blunt head injury cases.KEYWORDS: multislice computed tomography scan, postmortem, blunt head injury, autopsy

Role of 8-isoprostane, Matrix Gla Protein (MGP) and Bone Morphogenetic Protein-2 (BMP-2) in Vascular Calcification in Chronic Kidney Disease Wiwik Rositawati; Syakib Bakri; Gatot Susilo Lawrence; Andi Wijaya
The Indonesian Biomedical Journal Vol 5, No 2 (2013)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v5i2.71

BACKGROUND: Vascular calcification may be an important risk factor of cardiovascular disease in Chronic Kidney Disease (CKD). The pathobiology of vascular calcification in CKD is complex and involves some factors including inflammation, oxidative stress and balancing of calcification regulators. The aim of the study was to investigate the interaction between 8-isoprostane with calcification regulators such as matrix gla protein (MGP) and bone morphogenetic protein (BMP)-2 with vascular calciication in CKD.METHODS: A cross-sectional study was performed on 63 subjects undergoing haemodialysis maintenance for more than 3 months. Abdominal aortic calcification (AAC) was measured using a lateral abdominal X-ray for calcification in abdominal aorta, which is related to severity of calcific deposits at lumbar vertebral segment (L)1-L4. Serum levels of 8-isoprostane, MGP and BMP-2 were measured by enzyme-linked immunosorbent assay method.RESULTS: Results showed that 8-isoprostane levels were correlated with BMP-2 (r=0.266, p=0.018) and MGP levels (r=0.410, p≤0.001). MGP/BMP-2 levels ratio was correlated with AAC score (r=0.279, p=0.013). Subjects were then stratified into 3 groups based on AAC score: 0, 1-6 and ≥7. The highest mean of MGP levels was in AAC score 1-6 group, and the highest mean of 8-isoprostane levels was in AAC score ≥7. In the group of AAC score 0, 8-isoprostane levels were correlated with MGP levels (r=0.499, p=0.001) and MGP/BMP-2 levels ratio (r=0.291, p=0.034). In AAC score 1-6 group, 8-isoprostane levels were correlated with BMP-2 (r=0.661, p=0.005) and MGP levels (r=0.569, p=0.017). In AAC score ≥7 group, MGP levels were positively correlated with AAC score (r=0.608, p=0.041). With multivariate logistic regression analyses, we identified that increased MGP/BMP-2 levels ratio (OR=12.436; 95% CI=1.595-96.971) was an independent predictor in aortic calcification event.CONCLUSION: We concluded that regulators of calcification including calcification inhibitor and promoter related to oxidative stress, were associated with vascular calcification in CKD. MGP levels were increased in the early of calcification and MGP/BMP-2 levels ratio was a strong predictor for vascular calcification in CKD.KEYWORDS: vascular calcification, CKD, oxidative stress, 8-isoprostane, MGP, BMP-2

Osteoprotegerin Serum Level is Associated with Severity of Coronary Artery Calcification in Non Diabetic Centrally Obese Men Trilis Yulianti; Antonia Anna Lukito; Andi Wijaya; Gatot Susilo Lawrence; Syakib Bakri
The Indonesian Biomedical Journal Vol 4, No 1 (2012)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v4i1.158

BACKGROUND: Osteoprotegerin (OPG) is produced by a variety of tissues including those of the cardiovascular system. Recent clinical studies have suggested a significant correlation between elevated OPG serum level and cardiovascular mortality. Since coronary artery calcification (CAC) is positively associated with cardiovascular disease (CVD) events, we carried out a study to investigate whether OPG serum level is associated with the severity of CAC in non diabetic centrally obese men.METHODS: A cross sectional study was done on seventy non diabetic centrally obese men. CAC score was determined by using dual source computed tomography (DSCT). OPG serum level was measured by enzyme-linked immunosorbent assay (ELISA) method. Statistical analysis was done with SPSS for windows ver 16. ANOVA was performed to analyze mean, maximum, minimum value, and standard deviation. Spearman correlation test was performed to determine the correlation between OPG serum level and CAC score. Significance value was defined as alpha level=0.05 based on two-tailed tests.RESULTS: OPG serum level was significantly correlated with CAC score. The severity of CAC increased with the increase of OPG level. Age was significantly correlated with OPG serum level and CAC score.CONCLUSIONS: Our data show that serum OPG level was associated with the severity of CAC, which highlights that OPG could be involved in the progression of CAC in non diabetic obese men.KEYWORDS: obesity, vascular calcification, osteoprotegerin, coronary artery calcification

Association of Free Fatty Acid (FFA), Fatty Acid Binding Protein (FABP) and Adiponectin with Tumor Necrosis Factor-alpha (TNF-alpha) and Interleukin-6 (IL-6) Among Obese Non Diabetic Males Yani Lina; Gatot Susilo Lawrence; Andi Wijaya
The Indonesian Biomedical Journal Vol 1, No 2 (2009)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v1i2.91

BACKGROUND: The prevalence of obesity has increased dramatically in recent years. It is commonly associated with type 2 diabetes, coronary artery disease, and hypertension. White adipose tissue (WAT) is a major site of energy storage and is important for energy homeostasis. WAT has been increasingly recognized as an important endocrine organ that secretes a number of biologically active “adipokines”. The resultant higher FFA, FABP4, FABP5 concentration; and lower concentration of adiponectin is known to be correlated with inflammation. The aim of this study was to observe the correlation between FFA, FABP4, FABP5 and adiponectin with TNF-α and Interleukin-6 as markers of inflammation.METHOD: The study was observational with a cross sectional design. The analysis was done on 69 male subjects aged 30-60 years with non diabetic abdominal obesity which is characterized by waist circumference (WC) 98.7±6.5 cm and fasting blood glucose 87.1±9.7 mg/dL. FFA testing was performed by enzymatic colorimetric assay; whereas FABP4, FABP5, TNF-α, adiponectin and IL-6 were performed by ELISA. All statistical calculations were performed with the SPSS 11.5 statistical software package. We used the Pearson or Spearman’s rho correlation coefficient to assess the correlation between various anthropometric and biochemical measures. We also used path analysis Lisrel 8.30 for Windows.RESULT: This study revealed that there was no correlation between FFA, FABP4 and adiponectin with TNF-α and Interleukin-6, whereas there was correlation between FABP5 with TNF- and Interleukin-6. This study also showed there were correlations between WC and hsCRP (r=0.314, p=0.000), WC and IL-6 (r=0.276, p=0.022), FFA and FABP4 (r=0.263, p=0.029), FABP4 and WC (r=0.249, p =0.039), FABP4 and BMI (r=0.311, p=0.009), FABP5 and TNF- (r=0.408, p=0.000), FABP5 and FABP4 (r=0.296, p=0.014), FABP5 and Interleukin-6 (r=0.248, p=0.04), Adiponectin and HDL-Cholesterol (r=0.301, p=0.012).CONCLUSION: Abdominal obesity might contribute to inflammation in obese nondiabetic males. This study indicated that in abdominal obesity, FFA may induce inflammation through FABP4 and FABP5. Advancing our understanding of the function and measurement of FABP4 and FABP5 serum concentration will give insight into the clinical diagnosis of obesity-related metabolic disorders.KEYWORDS: Obesity, Waist Circumference, Free Fatty Acid (FFA), Fatty Acid Binding Protein (FABP), Adiponectin, TNF-α, Interleukin-6, Inflammation

The Role of Angiopoietin-like Protein 3 and Fibroblast Growth Factor 21 to Lipolysis, Inflammation and Insulin Resistance in Indonesian Non-Diabetic Obese Male Yani Lina; Gatot Susilo Lawrence; Andi Wijaya; Suryani As'ad
The Indonesian Biomedical Journal Vol 2, No 2 (2010)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v2i2.117

BACKGROUND: Obesity is commonly associated with a systemic low grade inflammation and insulin resistance state. Although it is still being debated, increased lipolysis is known as one of the risk factors for inflammation and insulin resistance. Two factors already known to affect lipolysis are Angptl3, known as prolipolytic factor, and FGF21, known as antilipolytic factor. The aim of this study was to observe the role of Angptl3 and FGF21 to lipolysis, inflammation and insulin resistance in non diabetic obese male.METHODS: This was an observational study with cross sectional design. One hundred and thirty male subjects aged 30-60 years with non diabetic abdominal obesity characterized by waist circumference 97.32±5.63 cm and fasting blood glucose 90.19±8.78 mg/dL.RESULTS: The results of this study showed a correlation between Angptl3-FFA (r=0.203; p=0.021; R square=0.041; p=0.021), Angptl3-FABP4 (r=0.330; p=0.000; R square=0.109; p=0.000) and Angptl3-TNFα (r=0.288; p=0.001; R square=0.049; p=0.011). There was a correlation between FGF21-FABP4 (r=0.218, p=0.013; R square=0.047, p=0.013) and FGF21 HOMA-IR (r=0.308, p=0.000; R square=0.046, p=0.014).CONCLUSIONS: We conclude that Angptl3 may affect lipolysis and inflammation while FGF21 may affect lipolysis and insulin resistance. The increased FGF21 concentration might occur as a compensation (negative feedback mechanism) to reduce lipolysis and increase insulin sensitivity in non diabetic obese males. Further studies might be needed to observe Angptl3 and FGF21 profile in more severe obese population in Indonesia.KEYWORDS: obesity, lipolysis, inflammation, insulin resistance

Levels of Adiponectin and Soluble Tumor Necrosis Factor-α Receptor 2 (sNFαR2) in Obese Males with or without Fatty Liver Agus Sulaeman; Syarifuddin Wahid; Ali Sulaiman; Gatot Susilo Lawrence
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 12, NUMBER 1, April 2011
Publisher : The Indonesian Society for Digestive Endoscopy

Background: Increased lipolysis in obese patients will cause elevated free-fatty acid level leading to insulin resistance. There are varied inflammatory cytokines (sTNFαR2) and anti-inflammatory cytokines (adiponectin) in obese patients, with and without fatty liver (FL). The aim of this study was to determine sTNFαR2 and adiponectin levels in obese patients with and without fatty liver. Method: This study was an observational study with cross-sectional approach, which was conducted between September 2008 and August 2009. The patients were 94 obese male with waist circumference ≥ 90 cm based on criteria of the International Diabetes Federation. Fatty liver was detected by ultrasonography; while adiponectin and sTNFαR2 levels in blood were analyzed by using ELISA Method and blood examination at the clinical laboratory. Results: Levels of adiponectin and sTNFαR2 were different between obese patients with and without FL. The adiponectin level was 3.10 ± 1.14 in patients with FL and was 3.52 ± 1.07 in patients without FL; while the sTNFαR2 were 23.92 ± 6.00 (FL) and 20.61 ± 5.29 (without FL). In patients with low adiponectin level ( 3.33 µ g/L) and high sTNFαR2 level ( 21.78 pg/dL), there was relatively higher occurrence of fatty liver compared to the other patients. Conclusion: Obese patients with fatty liver have higher sTNFαR2 level than patients without fatty liver. Moreover, obese patients with fatty liver have lower adiponectin level compared to patients without fatty liver. Patients with low adiponectin level and high sTNFαR2 level have higher incidence of fatty liver than subjects with high adiponectin level and low sTNFαR2 level. Keywords: adiponectin, soluble tumor necrosis factor α receptor 2 (sTNFαR2), obese, fatty liver

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