Platelet-related biomarkers and leptin levels in overweight and obese Malaysians in a public university

Obesity is one of the main worldwide epidemics that leads to increase in serious health problems and reducing life expectancy. In solving this problem on obesity various missions have been executed on obesity by international health services recently. According to the latest reports, the prevalence of obese and overweight individuals have increased in most East Asian countries including Malaysia. Obesity increases the probability of various chronic diseases; exclusively type 2 diabetes mellitus, certain kinds of cancers, hypertension, dyslipidaemia and cardiovascular disease (CVD). Obesity also plays a pivotal role in the development of low-grade inflammation. In this way, some cytokines, hormones, transcription factors, bioactive lipids and signaling proteins have both immune and metabolic roles. Thus, in this study, we measured the levels of two cytokines, sCD40L and sP-selectin that can alter platelet function and play a major role in the pathogenesis of obesity-induced inflammation. Leptin another factor of interest that contributes to the pro-thrombotic state in obesity is also examined in this study. To evaluate the effects of platelet related cytokines and platelet parameters in obese respondents and its association with leptin in comparison with normal body mass index respondents, a cross-sectional study was conducted in 112 healthy normal, overweight and obese respondents of both genders in three different races groups (Malay, Chinese and Indian), aged 18 to 60 years old from August 2014 to November 2014. Respondents in this study were given a verbal explanation of the study and a respondent information sheet before signing a standardised consent form as evidence of written approval. Anthropometric variables, BMI and waist circumference (WC) were measured. The respondents were further divided into specified groups based on WHO criteria for BMI in Asian population. The control group comprised of respondents with normal BMI (18.5kg/m2 - 22.9 kg/m2) whereas the case group included respondents with BMI between 23 kg/m2 to 35 kg/m2 (overweight and obese). A patient’s pro-forma form was used to encompass information of the respondents. such as sociodemographic characteristics, family history, medical history, current medications, and some risk factors known to play a role in inflammation such as smoking, allergy history and alcohol consumption. Ten (10) milliliter of blood was drawn from the antecubital fossa by an expert phlebotomist and entered into appropriately labeled tubes whereby three (3) ml were in the EDTA tube for full blood count (FBC) measuring MPV (Mean Platelets Volume) and platelets count, whilst the remainder 7 ml was placed in plain tubes for evaluating sCD40L, leptin and sP-selectin by ELISA analysis. A total number of 56 cases and 56 controls were compared based on their BMI levels in the final analysis. There was a significant difference in the means of weight, height, BMI and WC between case and control groups (P<0.05). Most of the respondents who participated in our study were Malays (54.5%) followed by Chinese (26.8%) and Indians (18.7%). Sixty-one (54.5 %) respondents were female and 45.5% were male. The analysis of MPV, sCD40L, leptin and sP-selectin showed a statistically significant difference between obese, overweight and normal weight respondents (p<0.05). Based on our data, there was a significant difference in the mean of PLT between overweight females and males (p=0.005) also a significant difference in the mean of sCD40L between these two groups (p=0.02). Women had higher means of sCD40L, leptin, sP-sel and platelets count than men. In contrast, males had higher amount of MPV than females. In addition, a significant correlation was reported between the levels of sP-selectin with BMI (r=0.36, p=0.001) and WC (r=0.25,p=0.007). Also there was a statistically significant correlation between MPV with BMI (r=0.2, p=0.001) and WC (r=0.2, p=0.003). Our data showed that healthy fasting obese and overweight respondents have significantly higher levels of MPV than non-obese respondents. Increase MPV indicates that, platelets are more reactive in respondent with obesity. In addition, we found that obese respondents have higher level of sCD40L compared to overweight and normal groups, suggesting a pro-inflammatory state in obese respondents. A higher MPV and sP-sel level in obese respondents than overweight and normal weight indicates a higher aggregating activity of platelets in obesity. Level of leptin concentrations found to be correlating with BMI in healthy obese and non-obese respondents. Since leptin is a factor known to induce platelet activation and aggregation, thus it can increase the cardiovascular risks as well. In addition, an association of leptin with thrombosis and haemostatic disorders in obesity has been suggested. At the end of the study, we found no significant correlations between PLT, MPV and leptin with sP-sel and sCD40L. Therefore, it has not yet been established whether elevated platelet counts in obese respondents are associated with platelet activation. But we can suggest that obesity is accompanied by platelet activation and inflammation. Present study suggests determining the association between current markers with genetic and lipid profiling by future studies to disclose the risk of CVD by these markers in obese respondents.

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