Insulin sensitivity was inversely related to unadjusted left ventricular mass (r = -0.37, P<0.01), but this relationship disappeared after adjusting for body mass index.
Cross-Sectional (n=51)
Is insulin sensitivity independently related to left ventricular mass in previously untreated non-diabetic hypertensive patients?
Insulin sensitivity is not independently related to left ventricular mass when adjusting for body size in untreated hypertensive patients, challenging the hypothesis of a direct growth-promoting effect of insulin on the myocardium.
Effect estimate: r = -0.37
p-value: p=<0.01
OBJECTIVE: Insulin has been suggested to promote myocardial cell growth and the development of left ventricular (LV) hypertrophy. This study examines the possible relationship between LV mass and insulin sensitivity. DESIGN: Previously untreated non-diabetic hypertensive patients. PATIENTS: Fifty-one patients with mean age 51 +/- 8 years, body mass index (BMI) 25.9 +/- 3.2 kg/m2 and blood pressure 158/102 mmHg were included. LV mass was determined by echocardiography. Glucose metabolism was assessed by an euglycemic insulin clamp (40 mU/m2 body surface area/min). RESULTS: Insulin sensitivity index (MI) and insulin clearance were inversely related to LV mass (r = -0.37, P < 0.01 and -0.33, P < 0.05, respectively) and LV mass indexed to height (r = -0.33, P < 0.05 and -0.29, P < 0.05, respectively). C-peptide and fasting insulin were related to LV mass (r = 0.33, P < 0.05 and r = 0.36, P < 0.01, respectively) and LV mass indexed to height (r = 0.30, P < 0.05 and r = 0.34, P < 0.05, respectively). In contrast, when LV mass was indexed by body surface area there was no longer a relation to MI, insulin clearance, C-peptide or fasting insulin. When adjusting for BMI in a multiple regression analysis, MI and LV mass no longer showed a relation. Indeed, MI, insulin clearance, C-peptide and insulin were all strongly related to weight and BMI. CONCLUSION: Insulin sensitivity is related to body size in untreated hypertension. However, insulin sensitivity is not related to LV mass, if adjusting for body size. This does not support a direct growth-promoting effect of insulin on the myocardium. Insulin does not appear to be strongly involved in development of hypertensive LV hypertrophy.
Malmqvist et al. (Thu,) conducted a cross-sectional in Primary hypertension (n=51). Insulin sensitivity was evaluated on Relationship between left ventricular mass and insulin sensitivity index (r = -0.37, p=<0.01). Insulin sensitivity was inversely related to unadjusted left ventricular mass (r = -0.37, P<0.01), but this relationship disappeared after adjusting for body mass index.