title: Patients with dilated cardiomyopathy possess insulin resistance independently of cardiac dysfunction or serum tumor necrosis factor-alpha.
abstract: It has recently been reported that insulin resistance is prevalent in patients with dilated cardiomyopathy (DCM); however, it remains unclear whether insulin resistance is directly induced by DCM or if it is caused by congestive heart failure associated with DCM. We evaluated homeostasis model assessment insulin resistance (HOMA-R) in 14 patients with DCM in comparison with 9 patients with valvular heart diseases (VHD). We also measured the level of serum tumor necrosis factor (TNF)-alpha as a possible causative factor for inducing insulin resistance. Even after the adjustment for age, body mass index, and cardiac function, HOMA-R was significantly higher in patients with DCM than in those with VHD (P = 0.012) (mean +/- SEM: 3.51 +/- 0.59, and 0.80 +/- 0.64, respectively). The serum TNF-alpha level tended to be higher in patients with DCM than in those with VHD; however, the difference was not significant. In conclusion, patients with DCM possess insulin resistance independently of the severity of cardiac dysfunction or serum TNF-alpha, suggesting that insulin resistance in patients with DCM may be closely associated with the pathogenic condition of DCM itself.
authors.affiliation: Department of Medicine and Biosystemic Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Sakai
authors.forename: Toru
authors.initials: T
authors.lastname: Maruyama
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Katsuta
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Kogawa
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Akashi
authors.forename: Ken-Ichi
authors.initials: K
authors.lastname: Izumi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Tominaga
authors.forename: Suminori
authors.initials: S
authors.lastname: Kono
authors.forename: Seiho
authors.initials: S
authors.lastname: Nagafuchi
authors.forename: Mine
authors.initials: M
authors.lastname: Harada
mesh_terms: D000328:Adult; D000368:Aged; D002311:Cardiomyopathy, Dilated / Q000097:blood / Q000150:complications / Q000503:physiopathology*; D005260:Female; D006333:Heart Failure / Q000209:etiology / Q000503:physiopathology*; D006349:Heart Valve Diseases / Q000503:physiopathology; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D014409:Tumor Necrosis Factor-alpha / Q000097:blood*; D018487:Ventricular Dysfunction, Left / Q000209:etiology / Q000503:physiopathology*
chemical_list: D014409:Tumor Necrosis Factor-alpha