The Role of Insulin Sensitivity and Body Mass Index on Orthostatic Intolerance

Objective: To assess the effects of insulin sensitivity and anthropometric measurements on orthostatic intolerance syndromes. Methods: This is a retrospective study. Patients with history of syncope aged between 7-18 years were analyzed according to insulin sensitivity index and anthropometric measurements. Patients were grouped according to the head-up tilt test results (test positive and test negative). Also, patients who had positive tilt tests were divided into four subgroups such as vasodepressor vasovagal syncope (VVS), cardioinhibitory VVS, mixed VVS, and postural orthostatic tachycardia syndrome. Results: A total of 509 patients were included in the study. The mean age was 13.45 ± 2.82 years, and %64.4 were girls. The tilt test was positive in 214 patients and negative in 295. With the tilt test results, 173 patients were diagnosed with VVS and 41 patients (19 %) with POTS. There were no statistically significant difference between the groups according to the insulin sensitivity indices. In anthropometric measurements, a significant difference was observed between the two groups in height, height standard deviation score (SDS), BMI SDS and BMI p (p =0.008, p= 0.02, p=0.036, p=0.03, respectively). Conclusion: In our study, while the low BMI and being tall were the predisposing factors for VVS episodes especially in young girls, there was no relationship between the insulin sensitivity indices and positive head-up tilt test result. Providing appropriate treatment by shedding light on factors that cause recurrent syncope can contribute to the quality of life of patients.