title: One-hour postload plasma glucose levels and left ventricular mass in hypertensive patients.
abstract: OBJECTIVE
  Left ventricular hypertrophy (LVH), an independent risk factor for cardiovascular (CV) morbidity and mortality, recognizes a multifactorial pathogenesis. A plasma glucose value ≥155 mg/dL for the 1-h postload plasma glucose during an oral glucose tolerance test (OGTT) identifies subjects with normal glucose tolerance (NGT) at high risk for type 2 diabetes. We addressed the question if glucose tolerance status, particularly 1-h postload plasma glucose levels, affects left ventricular mass (LVM) and cardiac geometry in essential hypertension.
  
  
  METHODS
  We enrolled 767 never-treated hypertensive subjects, 393 women and 374 men (mean age 49.6 ± 8.5 years). All patients underwent an OGTT for the evaluation of glucose tolerance and standard echocardiography. LVM was calculated using the Devereux formula and normalized by body surface area (LVM index [LVMI]). Insulin sensitivity was assessed by the Matsuda index. Among all participants, 514 had NGT, 168 had impaired glucose tolerance (IGT), and 85 had type 2 diabetes. According to the 1-h postload plasma glucose cutoff point of 155 mg/dL, we divided normotolerant subjects into two groups: NGT <155 mg/dL (n = 356) and NGT ≥155 mg/dL (n = 158).
  
  
  RESULTS
  Subjects in the NGT ≥155 mg/dL group had worse insulin sensitivity than subjects in the NGT <155 mg/dL group (Matsuda index 63.9 vs. 88.8; P < 0.0001). Men with NGT ≥155 mg/dL had a higher LVMI than men with NGT <155 mg/dL (126.6 vs. 114.3 g/m(2); P = 0.002) and a different LVH prevalence (41.1 vs. 25.8%; P < 0.0001). At multiple regression analysis, 1-h glucose resulted in the major determinant of LVMI in normotolerant, IGT, and diabetic groups.
  
  
  CONCLUSIONS
  These data show that NGT ≥155 mg/dL subjects, compared with NGT <155 mg/dL subjects, have a higher LVMI and a greater prevalence of LVH similar to that of IGT and diabetic patients.
authors.affiliation: Department of Experimental and Clinical Medicine G. Salvatore, University Magna Græcia of Catanzaro, Catanzaro, Italy.
authors.forename: Angela
authors.initials: A
authors.lastname: Sciacqua
authors.forename: Sofia
authors.initials: S
authors.lastname: Miceli
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Carullo
authors.forename: Laura
authors.initials: L
authors.lastname: Greco
authors.forename: Elena
authors.initials: E
authors.lastname: Succurro
authors.forename: Franco
authors.initials: F
authors.lastname: Arturi
authors.forename: Giorgio
authors.initials: G
authors.lastname: Sesti
authors.forename: Francesco
authors.initials: F
authors.lastname: Perticone
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000503:physiopathology; D004452:Echocardiography; D005260:Female; D018149:Glucose Intolerance / Q000097:blood / Q000150:complications / Q000503:physiopathology; D005951:Glucose Tolerance Test; D006801:Humans; D006973:Hypertension / Q000097:blood*; D017379:Hypertrophy, Left Ventricular / Q000209:etiology / Q000473:pathology*; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis
chemical_list: D001786:Blood Glucose