Abdominal obesity, insulin resistance and hypertension: impact on left ventricular mass and function in women.
OBJECTIVE
To evaluate the relationship between central obesity, hyperinsulinemia and arterial hypertension with left ventricular mass and geometry in women.


METHODS
This study included 70 women (35-68 years), divided into four groups according to the presence of central obesity and hypertension. Visceral fat area was determined. Blood glucose and plasma insulin were determined before and two hours after an oral 75 g glucose load and the patients were submitted to cardilogical evaluation.


RESULTS
Compared to NT-OB, HT-OB presented higher levels of plasma insulin at 2h-OGTT (127.5 +/- 73.0 vs 86.8 +/- 42.7 microU/ml; p = 0.05), and reduced E wave/A wave ratio (E/A) (0.8 +/- 0.1 vs 1.2 +/- 0.3; p < 0.05). Compared to NT-NO, HT-NO showed higher insulin levels before glucose load (7.46 +/- 3.1 vs 4.32 +/- 2.1 microU/ml; p < 0.05), higher HOMAr (1.59 +/- 0.72 vs 0.93 +/- 0.48 mmol x mU/l2; p = 0.006), higher leptin level (19.1 +/- 9.6 vs 7.4 +/- 3.5 ng/ml; p = 0.028), greater VF area (84.40 +/- 55.7 vs 37.50 +/- 23.0 cm2; p = 0.036), increased IVSTd (9.6 +/- 1.2 vs 8.2 +/- 1.7 mm; p <0.05) and (LVM/height) (95.8 +/- 22.3 vs 78.4 +/- 15.5 g/m; p < 0.05). Multiple linear regression analysis showed age, BMI and fasting glucose as determinants on LVM/height (R2 = 0.59; p < 0.05).


CONCLUSIONS
Our results indicate an association among hypertension, central obesity and left ventricular hypertrophy through increases in sympathetic activity and insulin resistance.
Silva
Eliana A
EA
Universidade Federal de São Paulo-UNIFESP, Escola Paulista de Medicina-EPM-São Paulo, SP-Brazil. eliapsilva@uol.com.br
Flexa
Fernando
F
Zanella
Maria Teresa
MT
D000328:Adult; D000367:Age Factors; D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D004812:Epidemiologic Methods; D005260:Female; D005951:Glucose Tolerance Test; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000150:complications / Q000503:physiopathology*; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance / Q000502:physiology*; D050152:Intra-Abdominal Fat / Q000503:physiopathology*; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000150:complications / Q000503:physiopathology*; D012016:Reference Values; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology
D001786:Blood Glucose; D007328:Insulin