Subclinical impairment of left ventricular function in young obese women: contributions of polycystic ovary disease and insulin resistance.
BACKGROUND
Obesity and insulin resistance (IR) may produce disturbances of left ventricular (LV) function. Obese women with polycystic ovary syndrome (PCO), characterized by hormonal and metabolic abnormalities, are thought to be at particularly increased cardiovascular risk.


OBJECTIVE
We sought to determine the influence of IR on LV function in obese young women with and without PCO and without other comorbidities.


METHODS
This was a cross-sectional study.


METHODS
The study was performed at a university hospital.


METHODS
A total of 150 women aged younger than 40 yr with a body mass index (BMI) of 30 kg/m(2) or more was classified into three groups: with both PCO and IR, without PCO and with IR, and without either PCO or IR.


METHODS
Tissue Doppler-derived myocardial velocities, strain-rate and strain, and metabolic and hormonal measurements were calculated.


RESULTS
Subclinical impairment of LV systolic and diastolic function as indicated by lower peak strain (P < 0.001), peak systolic strain rate (P < 0.001), peak early diastolic strain rate (P < 0.001), and peak early diastolic velocity (P < 0.01) was demonstrated in both groups with IR. IR subjects with and without PCO did not differ in any LV function indices. Strain was independently associated with fasting insulin (beta = -0.39; P < 0.001), urinary albumin excretion (UAE) (beta = -0.36; P < 0.001), and BMI (beta = -0.22; P < 0.03), and peak early diastolic strain rate was associated with UAE (beta = -0.35; P < 0.001), fasting insulin (beta = -0.24; P < 0.02), BMI (beta = -0.23; P < 0.02), and SHBG (beta = 0.20; P < 0.04).


CONCLUSIONS
In obese young women, fasting insulin, BMI, SHBG, and UAE are independent correlates of impaired LV performance. The contribution of PCO to LV function abnormalities is linked to IR, but not to other hormonal aberrations associated with this condition.
Kosmala
Wojciech
W
University of Queensland Department of Medicine, Princess Alexandra Hospital, Ipswich Road, Brisbane, Q4102, Australia.
O'Moore-Sullivan
Trisha M
TM
Plaksej
Rafal
R
Kuliczkowska-Plaksej
Justyna
J
Przewlocka-Kosmala
Monika
M
Marwick
Thomas H
TH
D000328:Adult; D000419:Albuminuria / Q000150:complications; D000728:Androgens / Q000097:blood; D001794:Blood Pressure / Q000502:physiology; D003430:Cross-Sectional Studies; D025401:Echocardiography, Stress / Q000379:methods; D005080:Exercise Test; D005240:Feasibility Studies; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance / Q000502:physiology*; D009765:Obesity / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D012738:Sex Hormone-Binding Globulin / Q000032:analysis; D018487:Ventricular Dysfunction, Left / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D016276:Ventricular Function
D000728:Androgens; D007328:Insulin; D012738:Sex Hormone-Binding Globulin