| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Circulation, Vol 88, 1431-1436, Copyright © 1993 by American Heart Association
Z Sasson, Y Rasooly, T Bhesania and I Rasooly
BACKGROUND. Obesity in adults is associated with increased left ventricular
(LV) mass. The mechanism for this is unclear, however. We tested the
hypothesis that insulin resistance is an important independent contributing
factor to LV mass in the healthy obese population. METHODS AND RESULTS. The
study population consisted of 40 normotensive, nondiabetic, otherwise
healthy obese subjects with body mass index (BMI) > 25 kg/m2. LV mass
was echocardiographically determined according to the Penn convention,
using the formula of Devereux and Reichek. Insulin resistance was assessed
using indices derived from Intravenous Glucose Tolerance Test (IVGTT):
insulin level at baseline, insulin level at 90 minutes of IVGTT
(insulin-90), insulin integration over 90 minutes of IVGTT, and rate of
glucose disposal (k value). Insulin-90 (r = .61, P = .0001), k value (r =
.55, P = .003), insulin integration over 90 minutes (r = .46, P = .003),
basal insulin (r = .44, P = .005), and BMI (r = .59, P = .0001) were all
strongly correlated with LV mass by univariate analysis. No significant
correlation was found with blood pressure or age. In multivariate
regression analysis, only insulin-90 and k value correlated significantly
with LV mass (P = .03, P = .02, respectively), accounting for 50% of the
variance of LV mass, whereas the association with BMI became insignificant
(P = .2). CONCLUSIONS. LV mass in the normotensive nondiabetic obese
population is strongly associated with, and may be mediated by, the degree
of insulin resistance and its associated hyperinsulinemia, independent of
BMI and blood pressure.
ARTICLES
Insulin resistance is an important determinant of left ventricular mass in the obese
Department of Medicine, Wellesley Hospital, University of Toronto, Ontario, Canada.
This article has been cited by other articles:
 |
|
 |
|
  P. Velasquez-Mieyer, C. P. Neira, R. Nieto, and P. A. Cowan Review: Obesity and cardiometabolic syndrome in children Therapeutic Advances in Cardiovascular Disease, October 1, 2007; 1(1): 61 - 81. [Abstract] [PDF]
|
|
|
|
 |
|
 P. Poirier, T. D. Giles, G. A. Bray, Y. Hong, J. S. Stern, F. X. Pi-Sunyer, and R. H. Eckel Obesity and cardiovascular disease: pathophysiology, evaluation, and effect of weight loss. Arterioscler. Thromb. Vasc. Biol., May 1, 2006; 26(5): 968 - 976. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Poirier, T. D. Giles, G. A. Bray, Y. Hong, J. S. Stern, F. X. Pi-Sunyer, and R. H. Eckel Obesity and Cardiovascular Disease: Pathophysiology, Evaluation, and Effect of Weight Loss: An Update of the 1997 American Heart Association Scientific Statement on Obesity and Heart Disease From the Obesity Committee of the Council on Nutrition, Physical Activity, and Metabolism Circulation, February 14, 2006; 113(6): 898 - 918. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. M. Burchfiel, T. N. Skelton, M. E. Andrew, R. J. Garrison, D. K. Arnett, D. W. Jones, and H. A. Taylor Jr Metabolic Syndrome and Echocardiographic Left Ventricular Mass in Blacks: The Atherosclerosis Risk in Communities (ARIC) Study Circulation, August 9, 2005; 112(6): 819 - 827. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P Friberg, A Allansdotter-Johnsson, A Ambring, R Ahl, H Arheden, J Framme, A Johansson, D Holmgren, H Wahlander, and S Marild Increased left ventricular mass in obese adolescents Eur. Heart J., June 1, 2004; 25(11): 987 - 992. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. R. Peterson, A. D. Waggoner, K. B. Schechtman, T. Meyer, R. J. Gropler, B. Barzilai, and V. G. Davila-Roman Alterations in left ventricular structure and function in young healthy obese women: Assessment by echocardiography and tissue Doppler imaging J. Am. Coll. Cardiol., April 21, 2004; 43(8): 1399 - 1404. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Karason, L. Sjostrom, I. Wallentin, and M. Peltonen Impact of blood pressure and insulin on the relationship between body fat and left ventricular structure Eur. Heart J., August 2, 2003; 24(16): 1500 - 1505. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. De Michele, S. Panico, A. Iannuzzi, E. Celentano, A. V. Ciardullo, R. Galasso, L. Sacchetti, F. Zarrilli, M. G. Bond, and P. Rubba Association of Obesity and Central Fat Distribution With Carotid Artery Wall Thickening in Middle-Aged Women Stroke, December 1, 2002; 33(12): 2923 - 2928. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Ilercil, R. B. Devereux, M. J. Roman, M. Paranicas, M. J. O'Grady, E. T. Lee, T. K. Welty, R. R. Fabsitz, and B. V. Howard Associations of Insulin Levels With Left Ventricular Structure and Function in American Indians : The Strong Heart Study Diabetes, May 1, 2002; 51(5): 1543 - 1547. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Z. Goldstein, B. E. Hurwitz, M. M. Llabre, N. Schneiderman, M. Gutt, J. S. Skyler, R. J. Prineas, and R. P. Donahue Modeling Preclinical Cardiovascular Risk for Use in Epidemiologic Studies: Miami Community Health Study Am. J. Epidemiol., October 15, 2001; 154(8): 765 - 776. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Kuperstein, P. Hanly, M. Niroumand, and Z. Sasson The importance of age and obesity on the relation between diabetes and left ventricular mass J. Am. Coll. Cardiol., June 1, 2001; 37(7): 1957 - 1962. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N Chaturvedi, P M McKeigue, M G Marmot, and P Nihoyannopoulos A comparison of left ventricular abnormalities associated with glucose intolerance in African Caribbeans and Europeans in the UK Heart, June 1, 2001; 85(6): 643 - 648. [Abstract] [Full Text]
|
|
|
|
|
|
V. Palmieri, J. N. Bella, D. K. Arnett, J. E. Liu, A. Oberman, M.-Y. Schuck, D. W. Kitzman, P. N. Hopkins, D. Morgan, D. C. Rao, et al. Effect of Type 2 Diabetes Mellitus on Left Ventricular Geometry and Systolic Function in Hypertensive Subjects : Hypertension Genetic Epidemiology Network (HyperGEN) Study Circulation, January 2, 2001; 103(1): 102 - 107. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Y. Tsujita, N. Iwai, S. Tamaki, Y. Nakamura, M. Nishimura, and M. Kinoshita Genetic mapping of quantitative trait loci influencing left ventricular mass in rats Am J Physiol Heart Circ Physiol, November 1, 2000; 279(5): H2062 - H2067. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Q. Galvan, F. Galetta, A. Natali, E. Muscelli, A. M. Sironi, G. Cini, S. Camastra, and E. Ferrannini Insulin Resistance and Hyperinsulinemia : No Independent Relation to Left Ventricular Mass in Humans Circulation, October 31, 2000; 102(18): 2233 - 2238. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G.Y.H Lip, D.C Felmeden, F.L Li-Saw-Hee, and D.G Beevers Hypertensive heart disease. A complex syndrome or a hypertensive 'cardiomyopathy'? Eur. Heart J., October 2, 2000; 21(20): 1653 - 1665. [PDF]
|
|
|
|
|
|
J. S. Gottdiener, A. M. Arnold, G. P. Aurigemma, J. F. Polak, R. P. Tracy, D. W. Kitzman, J. M. Gardin, J. E. Rutledge, and R. C. Boineau Predictors of congestive heart failure in the elderly: the cardiovascular health study J. Am. Coll. Cardiol., May 1, 2000; 35(6): 1628 - 1637. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Z. Zemva and A. Zemva Ventricular Ectopic Activity, Left Ventricular Mass, Hyperinsulinemia, and Intracellular Magnesium in Normotensive Patients with Obesity Angiology, February 1, 2000; 51(2): 101 - 106. [Abstract] [PDF]
|
|
|
|
 |
|
 A. M. Grandi, P. Zanzi, A. Fachinetti, G. Gaudio, L. Ceriani, A. Bertolini, L. Guasti, and A. Venco Insulin and Diastolic Dysfunction in Lean and Obese Hypertensives : Genetic Influence Hypertension, December 1, 1999; 34(6): 1208 - 1214. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. Palmieri, G. de Simone, M. J. Roman, J. E. Schwartz, T. G. Pickering, and R. B. Devereux Ambulatory Blood Pressure and M;etabolic Abnormalities in Hypertensive Subjects With Inappropriately High Left Ventricular Mass Hypertension, November 1, 1999; 34(5): 1032 - 1040. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. L. Fraser, D. E. Tullis, Z. Sasson, R. H. Hyland, K. S. Thornley, and P. J. Hanly Pulmonary Hypertension and Cardiac Function in Adult Cystic Fibrosis: Role of Hypoxemia Chest, May 1, 1999; 115(5): 1321 - 1328. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. A. Phillips, L. R. Krakoff, A. Dunaif, D. T. Finegood, R. Gorlin, and S. Shimabukuro Relation among Left Ventricular Mass, Insulin Resistance, and Blood Pressure in Nonobese Subjects J. Clin. Endocrinol. Metab., December 1, 1998; 83(12): 4284 - 4288. [Abstract] [Full Text]
|
|
|
|
 |
|
 L. A. Velloso, C. R.O. Carvalho, F. A. Rojas, F. Folli, and M. J.A. Saad Insulin signalling in heart involves insulin receptor substrates-1 and -2, activation of phosphatidylinositol 3-kinase and the JAK 2-growth related pathway Cardiovasc Res, October 1, 1998; 40(1): 96 - 102. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. D. Gatzka, J. D. Cameron, B. A. Kingwell, and A. M. Dart Relation Between Coronary Artery Disease, Aortic Stiffness, and Left Ventricular Structure in a Population Sample Hypertension, September 1, 1998; 32(3): 575 - 578. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Karason, I. Wallentin, B. Larsson, and L. Sjostrom Effects of obesity and weight loss on left ventricular mass and relative wall thickness: survey and intervention study BMJ, October 11, 1997; 315(7113): 912 - 916. [Abstract] [Full Text]
|
|
|
|
|
|
Y. Ohya, I. Abe, K. Fujii, K. Kobayashi, U. Onaka, and M. Fujishima Intima-Media Thickness of the Carotid Artery in Hypertensive Subjects and Hypertrophic Cardiomyopathy Patients Hypertension, January 1, 1997; 29(1): 361 - 365. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y. Ohya, I. Abe, K. Fujii, S. Ohmori, U. Onaka, K. Kobayashi, and M. Fujishima Hyperinsulinemia and Left Ventricular Geometry in a Work-Site Population in Japan Hypertension, March 1, 1996; 27(3): 729 - 734. [Abstract] [Full Text]
|
|
|
|
|
|
A. Cittadini, H. Stromer, S. E. Katz, R. Clark, A. C. Moses, J. P. Morgan, and P. S. Douglas Differential Cardiac Effects of Growth Hormone and Insulin-like Growth Factor1 in the Rat : A Combined In Vivo and In Vitro Evaluation Circulation, February 15, 1996; 93(4): 800 - 809. [Abstract] [Full Text]
|
|