Relación entre hiperinsulinemia, disfunción diastólica e hipertrofia del ventrículo izquierdo en pacientes con hipertensión arterial sistémica / Association of hyperinsulinemia with left ventricular hypertrophy and diastolic dysfunction in patients with hypertension
Rev. méd. Chile
; 135(9): 1125-1131, sept. 2007. graf, tab
Article
in Es
| LILACS
| ID: lil-468200
Responsible library:
BR1.1
ABSTRACT
Background:
Hypertension is the main independent cardiovascular risk factor. However, there are additional factors that induce organic damage.Aim:
To assess the association between hyperinsulinemia, ventricular hypertrophy and left ventricular diastolic function. Patients andMethods:
Seventy-four patients aged 30 to 65 years, with mild or moderate systemic hypertension, with overweight or mild obesity and normal glucose tolerance curve (GTC), were studied. Serum insulin was measured during GTC. The maximum levels of insulin and glucose were observed 60 minutes after the oral glucose load and they were expressed as rG/1. Patients were stratified in three groups according to their glucose and insulin fasting levels (I0) and post-glucose challenge levels (rG/I) Group 1 (normoinsulinemic patients) I0 <17 mU/mL and rG/I >2 (2.45+0.4). Group 2 (post-prandial hyperinsulinemic patients) I0 <17 mU/mL and rG/I <2> 1 (1.34+0.3). Group 3 (persistently hyperinsulinemic patients) I0 >17 mU/mL and <1 (0.7+0.3). Left ventricular mass and its diastolic function were measured by Doppler echocardiography.Results:
No differences in blood pressure or age were observed between groups. There was a negative correlation between ventricular mass and rG/1 (r =-0.282, p =0.015). Left ventricular diastolic dysfunction was significantly more deteriorated in group 3, as compared with group 1 (p <0.001 ANOVA). There was a significant correlation between g/GI and diastolic dysfunction (r =0.232 p =0.047).Conclusions:
Fasting, post challenge hyperinsulinemia and a rG/I <1 are associated with higher ventricular mass and left ventricular diastolic dysfunction, independent of blood pressure and age.Key words
Full text:
1
Index:
LILACS
Main subject:
Hypertrophy, Left Ventricular
/
Ventricular Dysfunction, Left
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Hyperinsulinism
/
Hypertension
Type of study:
Observational_studies
/
Prevalence_studies
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
Language:
Es
Journal:
Rev. méd. Chile
Journal subject:
MEDICINA
Year:
2007
Type:
Article