Key result
BMI, smoking, age, daily physical activity, LVEF, and etiology of heart failure explained 60% of the variance in insulin sensitivity among male patients with chronic heart failure.
Why the study?
What are the determinants of insulin sensitivity in male patients with chronic heart failure?
Cohort (n=57)
What are the determinants of insulin sensitivity in male patients with chronic heart failure?
In male patients with chronic heart failure, insulin sensitivity is primarily determined by BMI, smoking, age, and daily physical activity, with LVEF and etiology playing moderate roles.
Identifies modifiable correlates of insulin sensitivity in male HF; hypothesis-generating and should not yet change practice.
OBJECTIVE: To describe the determinants of insulin sensitivity (IS) in chronic heart failure (CHF), we created a model in which the influence of lifestyle factors and etiology of heart failure on IS were incorporated concomitantly with age, left ventricular ejection fraction (LVEF) and parameters of body composition. DESIGN: Observational cohort study. SETTING: Outpatient clinic for chronic heart failure. PATIENTS: Fifty-seven male CHF patients [NYHA class II-III, age 61+/-9 years, body mass index (BMI) 26.9+/-3.3 kg/m2 (mean+/-S.D.)]. INTERVENTIONS: Euglycemic hyperinsulinemic clamp, cycle ergometry, anthropometric measurements, LVEF and a physical activity questionnaire. MAIN OUTCOME MEASURES: A model explaining the variance of IS in CHF. RESULTS: IS was 18.2+/-8.6 microg.kg(-1).min(-1).mU(-1).l(-1), fasting insulin level was 15.9+/-11.0 mU/l and fasting glucose level was 5.5+/-0.6 mmol/l. Peak VO2 was 19.1+/-4.9 ml.kg(-1).min(-1) and LVEF 26.2+/-7.1%. IS was inversely associated with fasting insulin concentration (r=-0.50, P<0.001) and BMI (r=-0.54, P<0.001). After controlling for BMI, IS also revealed a correlation with age (r=-0.36, P<0.01). The model explained 60% of variance in IS: BMI contributed 20%, smoking 17%, age 17% and physical activity in daily life (DPA) 16% (all P<0.05) to the variance of IS, whereas LVEF (9%) and etiology of heart failure (8%) contributed moderately. CONCLUSIONS: In CHF patients, IS is for a major part predicted by BMI, smoking, age, daily physical activity, LVEF and etiology of heart failure.
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Sabelis et al. (2003) conducted a cohort in Chronic heart failure (n=57). Lifestyle and clinical factors (BMI, smoking, age, physical activity, LVEF, etiology) was evaluated on Variance of insulin sensitivity in chronic heart failure. BMI, smoking, age, daily physical activity, LVEF, and etiology of heart failure explained 60% of the variance in insulin sensitivity among male patients with chronic heart failure.
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