title: Creatinine and insulin predict cardiac mass in drug-naïve hypertensive patients.
abstract: BACKGROUND
  Blood pressure (BP) affects hypertensive left ventricular mass (LVM), explaining 10-25% of its variation. Thus, it is plausible that other factors operate in this process. Reduced kidney function is associated with increased LVM.
  
  
  METHODS
  We enrolled 1000 untreated hypertensives with serum creatinine ≤ 1.5mg/dL and without proteinuria. BP was measured by standard sphygmomanometer. LVM was calculated with the Devereux formula and indexed by body surface area (LVMI). Anthropometric and the following laboratory parameters were measured: plasma glucose, serum insulin, cholesterol, triglyceride, creatinine and e-GFR (CKD-EPI equation).
  
  
  RESULTS
  On univariate analysis, both insulin (r=0.44, P<0.0001) and creatinine (r=0.37, P<0.001) were directly related to LVMI. In multivariate regression analysis insulin resulted the first factor in rank explaining the variability in LVMI (semipartial r=0.34,P<0.001), followed by creatinine. Fasting insulin interacts with creatinine in explaining LVM variability: 0.1mg/dL increase in creatinine produces an increase of 8.1g/m(2) in LVMI in patients with higher plasma insulin (upper quartiles).
  
  
  CONCLUSIONS
  Independently of other risk factors, fasting insulin and serum creatinine contribute to explain LVM development in hypertensives with preserved renal function; insulin interacts with creatinine in explaining LVM variability in these patients.
authors.affiliation: Department of Experimental and Clinical Medicine G. Salvatore, University Magna Græcia of Catanzaro, V.le Europa, 88100 Catanzaro, Italy.
authors.forename: Sofia
authors.initials: S
authors.lastname: Miceli
authors.forename: Raffaele
authors.initials: R
authors.lastname: Maio
authors.forename: Maria
authors.initials: M
authors.lastname: Perticone
authors.forename: Giovanni
authors.initials: G
authors.lastname: Tripepi
authors.forename: Angela
authors.initials: A
authors.lastname: Sciacqua
authors.forename: Deborah
authors.initials: D
authors.lastname: Mazzaferro
authors.forename: Giorgio
authors.initials: G
authors.lastname: Sesti
authors.forename: Francesco
authors.initials: F
authors.lastname: Perticone
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D003404:Creatinine / Q000097:blood*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood* / Q000175:diagnosis* / Q000453:epidemiology; D017379:Hypertrophy, Left Ventricular / Q000097:blood* / Q000175:diagnosis* / Q000453:epidemiology; D007328:Insulin / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012307:Risk Factors; D055815:Young Adult
chemical_list: D015415:Biomarkers; D007328:Insulin; D003404:Creatinine