[Association of hyperinsulinemia with left ventricular hypertrophy and diastolic dysfunction in patients with hypertension].
BACKGROUND
Hypertension is the main independent cardiovascular risk factor. However, there are additional factors that induce organic damage.


OBJECTIVE
To assess the association between hyperinsulinemia, ventricular hypertrophy and left ventricular diastolic function.


METHODS
Seventy-four patients aged 30 to 65 years, with mild or moderate systemic hypertension, with overweight or mild obesity and normal glucose tolerance curve (GTC), were studied. Serum insulin was measured during GTC. The maximum levels of insulin and glucose were observed 60 minutes after the oral glucose load and they were expressed as rG/1. Patients were stratified in three groups according to their glucose and insulin fasting levels (I0) and post-glucose challenge levels (rG/I): Group 1 (normoinsulinemic patients) I0 <17 mU/mL and rG/I >2 (2.45+0.4). Group 2 (post-prandial hyperinsulinemic patients) I0 <17 mU/mL and rG/I <2> 1 (1.34+0.3). Group 3 (persistently hyperinsulinemic patients) I0 >17 mU/mL and <1 (0.7+0.3). Left ventricular mass and its diastolic function were measured by Doppler echocardiography.


RESULTS
No differences in blood pressure or age were observed between groups. There was a negative correlation between ventricular mass and rG/1 (r =-0.282, p =0.015). Left ventricular diastolic dysfunction was significantly more deteriorated in group 3, as compared with group 1 (p <0.001 ANOVA). There was a significant correlation between g/GI and diastolic dysfunction (r =0.232 p =0.047).


CONCLUSIONS
Fasting, post challenge hyperinsulinemia and a rG/I <1 are associated with higher ventricular mass and left ventricular diastolic dysfunction, independent of blood pressure and age.
Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, México. came_1@lycos.com
Ernesto Germán
EG
Cardona-Muñoz
David
D
Cardona-Müller
Sylvia
S
Totsuka-Sutto
Carlos Martín
CM
Nuño-Guzmán
Sara
S
Pascoe-González
Marina
M
Romero-Prado
Alejandra G
AG
Miranda-Díaz
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure / Q000502:physiology; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D015150:Echocardiography, Doppler; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D006946:Hyperinsulinism / Q000097:blood* / Q000150:complications; D006973:Hypertension / Q000097:blood* / Q000150:complications; D017379:Hypertrophy, Left Ventricular / Q000097:blood* / Q000150:complications; D007328:Insulin / Q000097:blood; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood; D012016:Reference Values; D018487:Ventricular Dysfunction, Left / Q000097:blood* / Q000150:complications
D001786:Blood Glucose; D007328:Insulin