Left ventricular hypertrophy and insulin resistance in adults from an urban community in The Gambia: cross-sectional study.
OBJECTIVE
To determine the association between left ventricular hypertrophy and insulin resistance in Gambians.


METHODS
Cross-sectional study.


METHODS
Outpatient clinics of Royal Victoria Teaching Hospital and Medical Research Council Laboratories in Banjul.


METHODS
Three hundred and sixteen consecutive patients were enrolled from outpatient clinics. The data of 275 participants (89 males) were included in the analysis with a mean (± standard deviation) age of 53.7 (±11.9) years.


METHODS
A questionnaire was filled and anthropometric measurements were taken. 2-D guided M-mode echocardiography, standard 12-1ead electrocardiogram, fasting insulin and the oral glucose tolerance test were performed.


METHODS
The Penn formula was used to determine the left ventricular mass index, 125 g/m2 in males and 110 g/m2 in females as the cut-off for left ventricular hypertrophy. Using the fasting insulin and fasting glucose levels, the insulin resistance was estimated by the homeostatic model assessment formula. Logistic regression analysis was used to determine the association between left ventricular hypertrophy and insulin resistance.


RESULTS
The mean Penn left ventricular mass index was 119.5 (±54.3) and the prevalence of Penn left ventricular mass index left ventricular hypertrophy was 41%. The mean fasting glucose was 5.6 (±2.5) mmol/l, fasting insulin was 6.39 (±5.49) μU/ml and insulin resistance was 1.58 (±1.45). There was no association between Penn left ventricular mass index left ventricular hypertrophy and log of insulin resistance in univariate (OR = 0.98, 95% CI = 0.80-1.19, p = 0.819) and multivariate logistic regression (OR = 0.93, 95% CI = 0.76-1.15, p = 0.516) analysis.


CONCLUSIONS
No association was found in this study between left ventricular hypertrophy and insulin resistance in Gambians and this does not support the suggestion that insulin is an independent determinant of left ventricular hypertrophy in hypertensives.
Department of Medicine, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Bernard Cudjoe
BC
Nkum
Department of Medicine, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Frank Botsi
FB
Micah
Department of Medicine, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Theophilus C
TC
Ankrah
Department of Medicine, Royal Victoria Teaching Hospital, Banjul, The Gambia.
Ousman
O
Nyan
D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D005714:Gambia / Q000453:epidemiology; D005951:Glucose Tolerance Test; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000453:epidemiology*; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D012111:Residence Characteristics; D014505:Urban Population / Q000706:statistics & numerical data*