Relationship of insulin sensitivity and left ventricular mass in uncomplicated obesity.
OBJECTIVE
We studied uncomplicated obesity as a model to evaluate the influence of insulin sensitivity per se on left ventricular mass (LVM) and geometry.


METHODS
We selected 50 obese subjects (BMI > 30 kg/m(2); 38 women and 12 men; mean age, 38.4 +/- 10 years; BMI, 36.4 +/- 10.5 kg/m(2)) with normal blood pressure, glucose tolerance, and plasmatic lipid levels. Thirty lean subjects formed the control group. Each subject underwent euglycemic insulin clamp (7 pmol/min per kg) to evaluate whole body glucose use (M index) and echocardiogram to calculate LVM and indexed LVM.


RESULTS
Insulin-resistant obese subjects had higher LVM, LVM/h(2.7), LVM/body surface area, and LVM/fat-free mass(kg) (p = 0.001; p = <0.001 p = 0.001, and p = 0.04, respectively) than obese subjects with normal insulin sensitivity. Multivariate regression analysis showed that M index was the strongest independent correlate of LVM (r(2) = 0.34; p = 0.03).


CONCLUSIONS
Our findings showed that insulin resistance, in uncomplicated obesity, is associated with an increased LVM and precocious changes of left ventricular geometry, whereas preserved insulin sensitivity is not associated with increased LVM.
Iacobellis
Gianluca
G
Endocrinology Section, Department of Clinical Sciences, University La Sapienza, Rome, Italy. gianluca.iaco@tin.it
Ribaudo
Maria Cristina
MC
Zappaterreno
Alessandra
A
Vecci
Elio
E
Tiberti
Claudio
C
Di Mario
Umberto
U
Leonetti
Frida
F
D000328:Adult; D015992:Body Mass Index; D015150:Echocardiography, Doppler; D005215:Fasting; D005260:Female; D015309:Glucose Clamp Technique; D005951:Glucose Tolerance Test; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000150:complications*; D007333:Insulin Resistance; D020738:Leptin / Q000097:blood; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D012044:Regression Analysis
D020738:Leptin