Abstract

Central obesity is associated with increased level and activity of endothelin-1. The waist and hip circumferences are simple indicators of central obesity. Waist circumference correlates with visceral adiposity, whereas hip circumference associates with gluteofemoral peripheral adiposity. Both measurements have independent and opposite correlation with coronary artery disease (CAD) risk factors. The relation between serum endothelin-1 in stable CAD and both parameters of central obesityneeds to be investigated. This study aims to examine the correlation between serum endothelin-1 level and waist and hip circumferences as parameters of central obesity in patients with stable CAD. This was a cross-sectional study. Consecutive subjects were enrolled among those who underwent elective coronary angiography with significant CAD. Serum endothelin-1 was measured from peripheral blood samples taken before coronary angiography procedure. The measurement of waist circumference, hip circumference, and ratio derived from them, was performed. Central obesity was determined by waist circumference cut-off for Indonesian population. The correlation analysis was performed with Pearson test. The multivariate analysis was performed with multiple linear regression test. The comparison of serum endothelin-1 level between groups was performed with Student T test. We enrolled 50 subjects. The majority of subjects was male (80.0%), hypertensive (86.0%), dyslipidemic (68%) and smoker (52%). Most subjects had history of acute coronary syndrome (64%). Mean waist circumference was 87.6 +/- SD cm, hip circumference was 95.3 cm +/- SD, mean waist-to-hip ratio was 0.92 +/- SD and mean waist-to-height ratio was 0.54 +/- SD. Central obesity occurred in 32% of subjects. Mean serum endothelin-1 level was 2.2 ± 0.7 pg/mL. Serum endothelin-1 level tended to be higher in subjects with central obesity as compared to those without. Serum endothelin-1 level was significantly correlated with age, hemoglobin level, waist circumference (coefficient of 0.311, p value = 0.023) and hip circumference (coefficient of 0.359, p value = 0.010). Multivariable analysis indicated that age (coefficient of -0.353, p value = 0.007) and hip circumference (coefficient of 0.335, p value = 0.011) were independently correlated with serum endothelin-1. For conclusion, in patients with stable CAD, serum endothelin-1 was positively correlated with both waist circumference and hip circumference. Hip circumference independently and positively correlated with serum endothelin-1 level.

Highlights

  • Cardiovascular disease (CVD) is one of the leading causes of death in many countries [1, 2]

  • Results of our study indicated that in patients with angiographycally-proven stable coronary artery disease (CAD), serum endothelin-1 level was positively correlated with both waist circumference and hip circumference

  • Serum endothelin1 tended to be higher in stable CAD patients with central obesity and patients with body mass index (BMI)-derived obesity compared to their counterparts

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Summary

Introduction

Cardiovascular disease (CVD) is one of the leading causes of death in many countries [1, 2]. In Indonesia, besides these risk factors, obesity, especially central obesity, continues to increase significantly and contributes meaningfully to CVD [4]. Individual with central obesity has an excess of visceral adiposity which is associated with sedentary lifestyle and metabolic diseases such as diabetes mellitus, hypertension, and dyslipidemia [5]. It adds multiple burdens of CVD risk factors. The increase in central obesity-related morbidity in Indonesia challenge CVD risk factor controls in a country which still struggles to implement CVD prevention program such as tobacco control policy, promotion of healthy diet and endorsement of healthy lifestyle [5]

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