title: Left ventricular concentric remodeling rather than left ventricular hypertrophy is related to the insulin resistance syndrome in elderly men.
abstract: BACKGROUND
  Associations between left ventricular (LV) geometry and the insulin resistance syndrome have been found, mostly in small studies of middle-aged hypertensives. The purpose of this study was to elucidate these associations through the use of a large sample of elderly men.
  
  
  RESULTS
  We investigated 475 men (157 hypertensives) 71 years of age who were attending a population-based health survey in Uppsala County with echocardiography, oral glucose tolerance test (OGTT), hyperinsulinemic euglycemic clamp, and lipid and 24-hour ambulatory blood pressure monitoring. LV relative wall thickness was significantly related to clamp insulin sensitivity index (r=-0.14), fasting insulin, 32-33 split proinsulin, triglycerides, nonesterified fatty acids, OGTT glucose and insulin levels, waist-to-hip ratio, body mass index, 24-hour blood pressure, and heart rate (r=0.10 to 0.22). Only 24-hour systolic pressure (r=0. 15), OGTT 2-hour insulin (r=-0.10), and heart rate (r=-0.14) were significantly related to LV mass index. Comparing subjects with various LV geometry (normal, concentric remodeling and concentric and eccentric hypertrophy) showed that 24-hour heart rate, OGTT glucose and insulin levels, waist-to-hip ratio, and body mass index were significantly higher (P<0.001 to 0.05) and clamp insulin sensitivity index was significantly lower (P<0.01) in the concentric remodeling geometry group than in the normal LV geometry group. The 24-hour blood pressure was significantly higher in the concentric hypertrophy group than in the normal LV geometry group (P<0.001).
  
  
  CONCLUSIONS
  Several components of the insulin resistance syndrome were related to thick LV walls and concentric remodeling but less to LV hypertrophy in this population-based sample of elderly men.
authors.affiliation: Department of Public Health, Uppsala University, Sweden. Johan.Sundstrom@geriatrik.uu.se
authors.forename: J
authors.initials: J
authors.lastname: Sundström
authors.forename: L
authors.initials: L
authors.lastname: Lind
authors.forename: N
authors.initials: N
authors.lastname: Nyström
authors.forename: B
authors.initials: B
authors.lastname: Zethelius
authors.forename: B
authors.initials: B
authors.lastname: Andrén
authors.forename: C N
authors.initials: CN
authors.lastname: Hales
authors.forename: H O
authors.initials: HO
authors.lastname: Lithell
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose; D015992:Body Mass Index; D015331:Cohort Studies; D004452:Echocardiography; D015150:Echocardiography, Doppler; D015309:Glucose Clamp Technique; D006306:Health Surveys; D006339:Heart Rate; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging* / Q000453:epidemiology; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging* / Q000453:epidemiology; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D008297:Male; D009206:Myocardium / Q000378:metabolism / Q000473:pathology; D012307:Risk Factors; D020257:Ventricular Remodeling
chemical_list: D001786:Blood Glucose; D007328:Insulin