Glucose and insulin metabolism are important determinants of left ventricular mass in obese hypertensives.
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.
Kuperstein
R
R
Mount Sinai Hospital, University of Toronto, 600 University Avenue, Toronto, Ontario M5G 1X5, Canada.
Sasson
Z
Z
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
D007328:Insulin; D005947:Glucose