Leptin in reproduction and hypertension in pregnancy.

Leptin has important roles in numerous physiological functions, including those in the regulation of energy balance, and in immune and reproductive systems. However, in the recent years, evidence has implicated it in a number of obesity-related diseases, where its concentrations in serum are significantly elevated. Elevated serum leptin concentrations and increased placental leptin secretion have been reported in women with hypertensive disorders of pregnancy. Whether leptin is responsible for this disorder remains to be established. Leptin injections in healthy rats and mice during pregnancy result in endothelial activation, increased blood pressure and proteinuria. A potential role for leptin in the pathogenesis of pre-eclampsia is hypothesised, particularly in women who are overweight or obese where serum leptin concentrations are often elevated. This review summarises pertinent information in the literature on the role of leptin in puberty, pregnancy, and hypertensive disorders of pregnancy. In particular, the possible mechanism that may be involved in leptin-induced increase in blood pressure and proteinuria during pregnancy and the potential role of marinobufagenin in this disease entity. We hypothesise a significant role for oxidative stress in this, and propose a conceptual framework on the events that lead to endothelial activation, raised blood pressure and proteinuria following leptin administration.

Standardized ethanol-water extract of Ficus deltoidea Angustifolia reduces blood pressure in spontaneously hypertensive rats.

Ficus deltoidea is used in Malay traditional medicine for the treatment of a number of disorders, including hypertension. There is, however, no scientific evidence on its anti-hypertensive effects. This study, therefore, investigated the effects of a standardized ethanolic-water extract of Ficus deltoidea Angustifolia (FD-A) on blood pressure (BP) in spontaneously hypertensive rats (SHR). Male SHR with systolic BP of >150 were divided into 4 groups (n = 8) and given either FD-A (800 or 1000 mg kg-1 day-1) or losartan (10 mg kg-1 day-1) or 0.5 ml of distilled water (control) daily for 28 days. BP, body weight, food and water intake, serum and urinary electrolytes, endothelin-1 (ET-1), total antioxidant capacity (TAC) and components of the renin-angiotensin-aldosterone system were measured. Data were analyzed using ANOVA with statistical significance set at p < 0.05. Following treatment, BP, heart rate, and heart weight in FD-A and losartan-treated rats were significantly lower than those in the controls. Serum TAC and urinary calcium excretion were significantly higher, whereas serum ET-1 concentration was significantly lower in FD-A treated rats when compared to those in controls. No significant differences were found in the components of the renin-angiotensin-aldosterone system between controls and FD-A treated rats. In conclusion, FD-A when given daily at doses of either 800 or 1000 mg kg-1 day-1 body weight reduces BP in SHR. This effect does not seem to involve the renin-angiotensin-aldosterone-system but might involve some other mechanisms. Abbreviations: FD-A: Ficus deltoidea Angustifolia; ACE: Angiotensin-converting enzyme; SHR: Spontaneously hypertensive rats; SBP: Systolic blood pressure; DBP: Diastolic blood pressure; AUC: Area under curve; RAAS: Renin Angiotensin Aldosterone System.

Dysregulation of Glucose Homeostasis Following Chronic Exogenous Administration of Leptin in Healthy Sprague-Dawley Rats.

INTRODUCTION: Impaired glucose utilization is seen in chronic hyperleptinaemia associated conditions such as obesity and type 2 diabetes mellitus. It is unclear if this impaired glucose utilization is due to the effect of persistent hyperleptinaemia on insulin secretion from the beta cells of pancreas. AIM: To examine the effects of chronic leptin administration on plasma glucose regulation in rats. MATERIALS AND METHODS: Glucose challenge curves were plotted for male Sprague-Dawley rats treated with either normal saline (Control; n=8) or subcutaneous leptin injection for 42 days (60 µg/kg body weight/day; n=8). Plasma glucose and plasma insulin levels were measured at 0, 5, 10, 15, 20 and 25 minutes after glucose challenege. Skeletal muscle tissue was collected at the end of a glucose challenge for glucose transporter-4 protein content, insulin receptor and glucose transporter-4 mRNA expression. Data were analysed using repeated measures and one-way ANOVA with post-hoc analysis. RESULTS: Chronic leptin treatment caused significantly higher fasting insulin level. Post glucose challenge, there was a significant increase in blood glucose levels and insulin level in the leptin treated rats. There was no significant difference in the skeletal muscle glucose transporter-4 content. However, leptin treated rats showed decreased mRNA expression of Insulin Receptor and glucose transporter-4 in the skeletal muscle. CONCLUSION: Leptin administration for 42 days caused hyperinsulinaemia and decreased the expression of insulin receptors in insulin sensitive tissues leading to the development of an insulin resistance-like state in the rats.

Documentation of self-care actions taken for somatic complaints by postmenopausal Malay women living in Kelantan Malaysia.

OBJECTIVE: The aim of this study was to document some of the self-care actions taken by women in Kelantan to manage their somatic symptoms associated with menopause. METHOD: A verified semi-structured questionnaire in the Malay language was administered to 326 naturally menopaused healthy women (mean age of 57.01+/-6.58 (S.D.) years) residing in Kelantan to determine the prevalence and types of self-care actions taken for their somatic complaints. RESULTS: Mean age at menopause was 49.4+/-3.4 (S.D.) years and 75% of these women were within the first 10 years of menopause. Of the four somatic symptoms, tiredness was the most prevalent followed by reduced level of mental concentration, musculoskeletal aches and pains, and backache. The prevalence of self-care actions was highest for backache (91%) and the lowest for reduced level of concentration (47.7%), and both prevalence and type of self-care action appear to depend upon the area of residence, and the educational level of the subject. Of those who took self-care actions, majority were from urban areas and with a higher educational level. Although HRT was used for all the four complaints, the use of pain relief tablets and traditional body massage was more commonly used for musculoskeletal aches and pains and backache than HRT. There was also a small fraction of women who had used the traditional herbs like 'akar kayu' and 'jamu' for these two complaints. CONCLUSION: It appears that the self-care actions used by postmenopausal women in Kelantan for their somatic complaints ranged from HRT to a combination of conventional, traditional, and alternative remedies. The fraction of women taking self-care action varied from symptom to symptom and the choice of self-care action also depended upon the education level, socio-economic status and place where the respondents were domiciled. There was a tendency for the more affluent and educated women to use more of the modern practices and slightly less of the traditional remedies whereas the rural women did the opposite. This is the first study of its kind in Kelantan documenting the self-care practices of menopausal women for their somatic complaints. Clearly more studies are needed to document these practices and the effectiveness of these self-care remedies.