TY - JOUR
T1 - Relation among left ventricular mass, insulin resistance, and blood pressure in nonobese subjects
AU - Phillips, Robert A.
AU - Krakoff, Lawrence R.
AU - Dunaif, Andrea
AU - Finegood, Diane T.
AU - Gorlin, Richard
AU - Shimabukuro, Seiichi
PY - 1998
Y1 - 1998
N2 - Because left ventricular (LV) mass (LVM) is a powerful predictor of future cardiovascular events, it is important to identify hemodynamic and nonhemodynamic factors that increase LVM. We studied the separate contribution to LVM of daily arterial blood pressure (BP) and insulin resistance in a consecutive series of 29 (mean ± SD age, 43 ± 13 yr) nonobese (body mass index, 24 ± 1.8 kg/m2), nondiabetic, glucose-tolerant subjects with untreated borderline or mild hypertension. The insulin sensitivity index (S(I)) was quantitatively determined from the frequently sampled iv glucose tolerance test. BP was characterized by ambulatory 24-h BP monitoring, and LVM index (LVMI) was determined by two-dimensional directed M-mode echocardiography. LVMI was directly related to 24-h mean BP (r = 0.47; P = 0.01). LMVI was also significantly related to S(I) (r = -0.43; P = 0.02). In this nonobese group, neither LVMI nor S(I) was related to body mass index or age. After adjustment for the influence of BP on LVMI, a significant relation remained between LVMI and S(i) (P < 0.05). We conclude that in nonobese subjects with high normal BP, insulin sensitivity is related to LVM independently of BP and may be an important modulator of LV growth. In addition to a reduction of arterial BP, optimal prevention of LV hypertrophy in hypertensives may require improved insulin sensitivity.
AB - Because left ventricular (LV) mass (LVM) is a powerful predictor of future cardiovascular events, it is important to identify hemodynamic and nonhemodynamic factors that increase LVM. We studied the separate contribution to LVM of daily arterial blood pressure (BP) and insulin resistance in a consecutive series of 29 (mean ± SD age, 43 ± 13 yr) nonobese (body mass index, 24 ± 1.8 kg/m2), nondiabetic, glucose-tolerant subjects with untreated borderline or mild hypertension. The insulin sensitivity index (S(I)) was quantitatively determined from the frequently sampled iv glucose tolerance test. BP was characterized by ambulatory 24-h BP monitoring, and LVM index (LVMI) was determined by two-dimensional directed M-mode echocardiography. LVMI was directly related to 24-h mean BP (r = 0.47; P = 0.01). LMVI was also significantly related to S(I) (r = -0.43; P = 0.02). In this nonobese group, neither LVMI nor S(I) was related to body mass index or age. After adjustment for the influence of BP on LVMI, a significant relation remained between LVMI and S(i) (P < 0.05). We conclude that in nonobese subjects with high normal BP, insulin sensitivity is related to LVM independently of BP and may be an important modulator of LV growth. In addition to a reduction of arterial BP, optimal prevention of LV hypertrophy in hypertensives may require improved insulin sensitivity.
UR - http://www.scopus.com/inward/record.url?scp=0032452554&partnerID=8YFLogxK
U2 - 10.1210/jc.83.12.4284
DO - 10.1210/jc.83.12.4284
M3 - Article
C2 - 9851765
AN - SCOPUS:0032452554
SN - 0021-972X
VL - 83
SP - 4284
EP - 4288
JO - Journal of Clinical Endocrinology and Metabolism
JF - Journal of Clinical Endocrinology and Metabolism
IS - 12
ER -