June 6, 2000Circulation
Left Ventricular Concentric Remodeling Rather Than Left Ventricular Hypertrophy Is Related to the Insulin Resistance Syndrome in Elderly Men
Key result
Left ventricular concentric remodeling was significantly associated with components of the insulin resistance syndrome, including lower clamp insulin sensitivity (P<0.01), compared to normal LV geometry.
Population
475 men, 71 years of age, attending a population-based health survey in Uppsala County
Design
Cross-sectional
Authors
Discussion
Loading...
Member takes
Implication
May inform LV assessment in insulin-resistant elderly men; leaves open causal role and prospective validation.
Key Points
- To determine the relationship between left ventricular geometry patterns and components of the insulin resistance syndrome in a population of elderly men.
- Evaluated 475 men aged 71 years (including 157 with hypertension) participating in a population-based health survey in Uppsala County.
- Assessed cardiac geometry and metabolic markers using echocardiography, oral glucose tolerance testing, hyperinsulinemic euglycemic clamp, lipid analysis, and 24-hour ambulatory blood pressure monitoring.
- Left ventricular relative wall thickness significantly correlated with clamp insulin sensitivity index (r = -0.14) and positively correlated with fasting insulin, triglycerides, glucose levels, body mass index, and 24-hour blood pressure (r = 0.10 to 0.22).
- Men with concentric remodeling showed significantly lower clamp insulin sensitivity (P < 0.01) and higher body mass index, waist-to-hip ratio, and glucose levels (P < 0.001 to 0.05) compared to those with normal left ventricular geometry.
- Left ventricular mass index correlated only with 24-hour systolic blood pressure (r = 0.15), 2-hour post-load insulin (r = -0.10), and heart rate (r = -0.14), demonstrating fewer metabolic associations than wall thickness.
Study Design
Type
Cross-Sectional (n=475)
Structured PICO
P
Population
475 men, 71 years of age (including 157 hypertensives), attending a population-based health survey in Uppsala County
O
Outcome
Association between left ventricular geometry (relative wall thickness and LV mass index) and components of the insulin resistance syndromesurrogate
Main Result
Effect estimate: r=-0.14
p-value: p=<0.01
In elderly men, components of the insulin resistance syndrome are more strongly associated with left ventricular concentric remodeling than with left ventricular hypertrophy.
Cite This Study
Sundström et al. (2000) conducted a cross-sectional in Insulin resistance syndrome (n=475). Left ventricular concentric remodeling vs. Normal left ventricular geometry was evaluated on Clamp insulin sensitivity index (r=-0.14, p=<0.01). Left ventricular concentric remodeling was significantly associated with components of the insulin resistance syndrome, including lower clamp insulin sensitivity (P<0.01), compared to normal LV geometry.