title: Glucose and insulin metabolism are important determinants of left ventricular mass in obese hypertensives.
abstract: BACKGROUND
  Obesity and hypertension, the major modifiable clinical determinants of left ventricular mass, are both associated with a state of insulin resistance.
  
  
  OBJECTIVE
  To determine the relationships between glucose and insulin metabolism and left ventricular mass in a group of obese, nondiabetic, hypertensive people.
  
  
  METHODS
  Twenty-two obese, nondiabetic, hypertensive people (10 men), free of coronary or valvular heart disease, with normal left ventricular function were studied. The mean age was 55+/-12 years, body mass index 32.8+/-4.8 kg/m2, and systolic and diastolic blood pressures 149.0+/-11.0 mmHg and 98.0+/-4.0 mmHg, respectively. Left ventricular mass corrected for height (LVM/Ht) and glucose and insulin metabolism (3 h intravenous glucose tolerance test) were measured after a four- to six-week washout period of any antihypertensive medication.
  
  
  RESULTS
  The mean LVM/Ht was 119.5+/-11.9 kg/m. The following metabolic measures correlated with LVM/Ht in a univariate analysis: total insulin integration area (r=0.54, P=0.008); fasting insulin (r=0.43, P=0.04); insulin at 90 min (r=0.54, P=0.013); and peak glucose levels (r=0.51, P=0.013). Stepwise multivariate linear regression analysis showed that only total insulin integration area (P=0.005) and peak glucose levels (P=0.01) correlated with LVM/Ht.
  
  
  CONCLUSIONS
  In obese, nondiabetic, hypertensive people, left ventricular mass is associated with circulating glucose and insulin levels.
authors.affiliation: Mount Sinai Hospital, University of Toronto, 600 University Avenue, Toronto, Ontario M5G 1X5, Canada.
authors.forename: R
authors.initials: R
authors.lastname: Kuperstein
authors.forename: Z
authors.initials: Z
authors.lastname: Sasson
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D004452:Echocardiography; D005260:Female; D005947:Glucose / Q000378:metabolism*; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000378:metabolism*; D007328:Insulin / Q000378:metabolism*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000378:metabolism*; D016277:Ventricular Function, Left
chemical_list: D007328:Insulin; D005947:Glucose