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Effect of insulin resistance on left ventricular structural changes in hypertensive patients

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dc.contributor.author Kaftan, H. Asuman
dc.contributor.author Evrengül, Harun
dc.contributor.author Tanriverdi, Halil
dc.contributor.author Kılıç, Mustafa
dc.date.accessioned 2019-08-16T11:34:55Z
dc.date.available 2019-08-16T11:34:55Z
dc.date.issued 2006
dc.identifier.issn 13492365 (ISSN)
dc.identifier.uri http://acikerisim.pau.edu.tr:8080/xmlui/handle/11499/4553
dc.description.abstract Both left ventricular (LV) hypertrophy and insulin resistance (IR) have often been demonstrated in patients with essential hypertension (EH). Insulin may exert a direct growth promoting effect on cardiomyocytes rather than affecting the LV internal diameter. The purpose of this study was to examine the effect of IR on LV geometry. We enrolled 105 patients (71 females, mean age, 49.2 ± 13.6 years) with recently diagnosed and untreated hypertension (blood press > 140 and/or 90 mmHg, fasting glucose < 110 mg/dL), and grouped them as normal (N) (39 patients, 26 females, mean age, 48.5 ± 14.7 years) if all M-mode echocardiographic measurements were within normal limits, concentric remodeling (CR) (22 patients, 15 females, mean age, 50.5 ± 14.8 years) if relative wall thickness was increased but left ventricular mass index (LVMI) was normal, concentric hypertrophy (CH) (13 patients, 9 females, mean age, 50.3 ± 10.8 years) if both ventricular thicknesses and the LVMI were increased, and eccentric hypertrophy (EH) (31 patients, 21 females, mean age, 48.6 ± 12.9 years) if ventricular thicknesses were normal, but LVMI was increased. Transthoracic echocardiography was performed in all subjects, and interventricular septal thickness (IVS), posterior wall thickness (PWT), sum of wall thickness (SWT), left ventricular end-diastolic internal diameter (LVED), relative wall thickness (RWT), and LVMI were recorded. Blood samples for routine biochemical examination and fasting insulin levels were obtained and then the homeostasis model assessment (HOMA) index was calculated by the formula: HOMA Index = Fasting Blood Glucose (mg/dL) × Immunoreactive Insulin (μU/mL)/405, for the assessment of IR. There were no significant differences among the groups with respect to age, blood pressure (BP) levels, fasting blood glucose (FBG), LDL-cholesterol (LDL-C), HDL-cholesterol (HDL-C), total cholesterol (TC), or triglyceride (TG) levels. Insulin levels were significantly higher in the CR and CH groups in comparison with the N group (P = 0.004), and the HOMA index was higher in the CH group compared to the N group (P = 0.024). In Pearson's correlation analysis, insulin was found to be directly correlated with IVS (r = 0.29, P = 0.002), SWT (r = 0.25, P = 0.009), and RWT (r = 0.33, P = 0.0001). The HOMA index was also directly correlated with IVS (r = 0.33, P = 0.001), SWT (r = 0.29, P = 0.002), and RWT (r = 0.29, P = 0.003). Cardiac changes in hypertensive patients include increased LVMI and altered LV geometry. The concentric LV geometry seen in hypertensive patients might be mediated, at least in part, by increased insulin levels and the HOMA index. Copyright © 2006 by the International Heart Journal Association.
dc.language.iso English
dc.relation.isversionof 10.1536/ihj.47.391
dc.rights info:eu-repo/semantics/openAccess
dc.subject Hypertension
dc.subject Insulin resistance
dc.subject Left ventricular structure
dc.subject glucose
dc.subject high density lipoprotein cholesterol
dc.subject immunoreactive insulin
dc.subject insulin
dc.subject low density lipoprotein cholesterol
dc.subject triacylglycerol
dc.subject adult
dc.subject age
dc.subject article
dc.subject blood chemistry
dc.subject blood pressure measurement
dc.subject cholesterol blood level
dc.subject controlled study
dc.subject correlation coefficient
dc.subject diet restriction
dc.subject female
dc.subject glucose blood level
dc.subject heart left ventricle hypertrophy
dc.subject heart left ventricle mass
dc.subject heart ventricle remodeling
dc.subject heart ventricle septum
dc.subject heart ventricle wall
dc.subject homeostasis
dc.subject human
dc.subject hypertension
dc.subject insulin blood level
dc.subject insulin resistance
dc.subject M mode echocardiography
dc.subject major clinical study
dc.subject male
dc.subject mathematical model
dc.subject priority journal
dc.subject statistical significance
dc.subject thickness
dc.subject transthoracic echocardiography
dc.subject triacylglycerol blood level
dc.subject Adult
dc.subject Blood Glucose
dc.subject Cholesterol, HDL
dc.subject Cholesterol, LDL
dc.subject Echocardiography
dc.subject Electrocardiography
dc.subject Female
dc.subject Homeostasis
dc.subject Humans
dc.subject Hypertrophy, Left Ventricular
dc.subject Insulin Resistance
dc.subject Male
dc.subject Middle Aged
dc.subject Triglycerides
dc.subject Ventricular Remodeling
dc.title Effect of insulin resistance on left ventricular structural changes in hypertensive patients
dc.type Article
dc.relation.journal International Heart Journal
dc.identifier.volume 47
dc.identifier.issue 3
dc.identifier.startpage 391
dc.identifier.endpage 400
dc.relation.publicationCategory Uluslararası Hakemli Dergi
dc.identifier.index Scopus
dc.identifier.index PubMed
dc.identifier.index WOS

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