Insulin resistance (p<0.0001) and waist-to-hip ratio (p<0.0001) were independently associated with a higher LV mass-to-volume ratio, independent of body mass index.
Observational (n=4,364)
Insulin resistance and central obesity (waist-to-hip ratio) are associated with concentric left ventricular remodeling independent of BMI, suggesting the cardiometabolic phenotype drives obesity-related cardiac changes.
p-value: p=<0.0001
Objectives We assessed in the Multi-Ethnic Study of Atherosclerosis (MESA) whether impaired fasting glucose, insulin resistance, and waist-to-hip ratio had effects on cardiac remodeling, independent of obesity. Background Recent studies suggest that central obesity and insulin resistance may be primary mediators of obesity-related cardiac remodeling independent of body mass index (BMI). Methods We investigated 4,364 individuals without diabetes in MESA. Impaired fasting glucose (IFG: 100-125 mg/dl) or insulin resistance (by homeostatic model assessment of insulin resistance, HOMA-IR) and waist-to-hip ratio (WHR) were used for cardiometabolic phenotyping. Multivariate linear regression analysis was used to determine the effects of the cardiometabolic markers on LV remodeling, assessed primarily through the LV mass-to-volume ratio obtained by cine cardiac magnetic resonance imaging. Results Individuals with IFG were more likely to be older, hypertensive, with increased prevalence of cardiometabolic risk factors regardless of BMI. In each quartile of BMI, individuals with above-median HOMA-IR, above-median WHR, or IFG had a higher LV mass-to-volume ratio (p<0.05 for all). HOMA-IR (p<0.0001), WHR (p<0.0001), and the presence of IFG (p=0.04), but not BMI (p=0.24), were independently associated with LV mass-to-volume ratio after adjustment for age, gender, hypertension, race, and dyslipidemia. Conclusions Insulin resistance and waist-to-hip ratio are associated with concentric LV remodeling independent of BMI. These results support the emerging hypothesis that the cardiometabolic phenotype, defined by insulin resistance and central obesity, may play a critical role in LV remodeling independently of BMI.
Shah et al. (Mon,) conducted a observational in Subclinical Left Ventricular Remodeling (n=4,364). Insulin resistance (HOMA-IR), impaired fasting glucose, and waist-to-hip ratio vs. Lower insulin resistance, normal fasting glucose, and lower waist-to-hip ratio was evaluated on LV mass-to-volume ratio (p=<0.0001). Insulin resistance (p<0.0001) and waist-to-hip ratio (p<0.0001) were independently associated with a higher LV mass-to-volume ratio, independent of body mass index.