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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
Cardona-Muñoz, Ernesto Germán; Cardona-Müller, David; Totsuka-Sutto, Sylvia; Nuño-Guzmán, Carlos Martín; Pascoe-González, Sara; Romero-Prado, Marina; Miranda-Díaz, Alejandra G.
  • Cardona-Muñoz, Ernesto Germán; Universidad de Guadalajara. Centro Universitario de Ciencias de la Salud. Guadalajara. MX
  • Cardona-Müller, David; Universidad de Guadalajara. Guadalajara. MX
  • Totsuka-Sutto, Sylvia; Universidad de Guadalajara. Centro Universitario de Ciencias de la Salud. Guadalajara. MX
  • Nuño-Guzmán, Carlos Martín; Universidad de Guadalajara. Centro Universitario de Ciencias de la Salud. Guadalajara. MX
  • Pascoe-González, Sara; Universidad de Guadalajara. Centro Universitario de Ciencias de la Salud. Guadalajara. MX
  • Romero-Prado, Marina; Universidad de Guadalajara. Centro Universitario de Ciencias de la Salud. Guadalajara. MX
  • Miranda-Díaz, Alejandra G; Universidad de Guadalajara. Centro Universitario de Ciencias de la Salud. Guadalajara. MX
Rev. méd. Chile ; 135(9): 1125-1131, sept. 2007. graf, tab
Artigo em Espanhol | LILACS | ID: lil-468200
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 and

Methods:

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.
Assuntos

Texto completo: DisponíveL Índice: LILACS (Américas) Assunto principal: Hipertrofia Ventricular Esquerda / Disfunção Ventricular Esquerda / Hiperinsulinismo / Hipertensão Tipo de estudo: Estudo observacional / Estudo de prevalência Limite: Adulto / Idoso / Feminino / Humanos / Masculino Idioma: Espanhol Revista: Rev. méd. Chile Assunto da revista: Medicina Ano de publicação: 2007 Tipo de documento: Artigo País de afiliação: México Instituição/País de afiliação: Universidad de Guadalajara/MX

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Texto completo: DisponíveL Índice: LILACS (Américas) Assunto principal: Hipertrofia Ventricular Esquerda / Disfunção Ventricular Esquerda / Hiperinsulinismo / Hipertensão Tipo de estudo: Estudo observacional / Estudo de prevalência Limite: Adulto / Idoso / Feminino / Humanos / Masculino Idioma: Espanhol Revista: Rev. méd. Chile Assunto da revista: Medicina Ano de publicação: 2007 Tipo de documento: Artigo País de afiliação: México Instituição/País de afiliação: Universidad de Guadalajara/MX