Left Ventricular Hypertrophy and Insulin Resistance in Adults from an Urban Community in the Gambia: Cross-Sectional Study

Nkum, Bernard C.; Micah, Frank B.; Ankrah, Theophilus C.; Nyan, Ousman

doi:10.1371/journal.pone.0093606

Cited by 16 publications

(18 citation statements)

References 33 publications

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“…In consistent with this, serum calcium level is inversely associated with insulin sensitivity measured with euglycaemic-hyperinsulinaemic clamp in the normocalcemic general population [ 44 ]. However, it is controversial whether insulin resistance plays a role in the pathogenesis of LVH, with some studies [ 45 , 46 ] showing a clear relationship while others [ 5 , 47 ] having no significant association between insulin resistance and LVH. In our study, there was an increased [OR (95% CI) = 1.486 (0.969-2.280)] but non-significant (p = 0.069) risk for LVH in individuals with insulin resistance (logarithmically transformed HOMA-IR as a continuous variable).…”

Section: Discussionmentioning

confidence: 99%

“…Several mechanisms such as insulin resistance, hyperlipidemia and diabetic kidney damage have been proposed to explain the relationship between T2DM and LVH. But after adjusting those potentially risk factors including glycaemia control, blood lipids, urinary albumin excretion rate and homeostasis model assessment insulin resistance (HOMA-IR), LVH is still a common condition in patients with T2DM [ 5 , 6 ]. Consequently, screening additional possible risk factors in the development of LVH in diabetic patients is an important subject of investigation.…”

Section: Introductionmentioning

confidence: 99%

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Cross-sectional analysis of serum calcium levels for associations with left ventricular hypertrophy in normocalcemia individuals with type 2 diabetes

et al. 2015

Cardiovasc Diabetol

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BackgroundLeft ventricular hypertrophy (LVH) is prevalent in patients with type 2 diabetes mellitus (T2DM). Recent studies show that an increase in albumin-adjusted serum calcium level is associated with an elevated risk of T2DM. We speculate that increased serum calcium levels in T2DM patients are related to LVH prevalence.MethodsIn this echocardiographic study, 833 normocalcemia and normophosphatemia patients with T2DM were enrolled. The associations between serum calcium and metabolic parameters, left ventricular mass index (LVMI), as well as the rate of LVH were examined using bivariate linear correlation, multivariate linear regression and logistic regression, respectively. The predictive performance of serum calcium for LVH was evaluated using the area under the receiver operating characteristic curve (AUC).ResultsPatients with LVH have significantly higher serum calcium than those without LVH. Serum calcium was positively associated with total cholesterol, triglycerides, low-density lipoprotein cholesterol, serum uric acid, HOMA-IR and fasting plasma glucose. Multivariate linear regression analysis demonstrated that serum calcium was independently associated with LVMI (p < 0.001). In comparison with patients in the lowest serum calcium quartile, the odds ratio (OR) for LVH in patients in the highest quartile was 2.909 (95% CI 1.792-4.720; p < 0.001). When serum calcium was analyzed as a continuous variable, per 1 mg/dl increase, the OR (95% CI) for LVH was [2.400 (1.552-3.713); p < 0.001]. Serum calcium can predict LVH (AUC = 0.617; 95% CI (0.577-0.656); p < 0.001).ConclusionsAlbumin-adjusted serum calcium is associated with an increased risk of LVH in patients with T2DM.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Cross-sectional analysis of serum calcium levels for associations with left ventricular hypertrophy in normocalcemia individuals with type 2 diabetes

et al. 2015

Cardiovasc Diabetol

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“…One hundred and eight consecutive normotensive patients (69 females) and 208 patients (138 females) with systemic hypertension on treatment were enrolled from outpatient clinics for our initial study [11] [12]. Three hundred and five participants (199 HPT, 199 females) out of the 316 with complete lipid results were included in this analysis.…”

Section: Resultsmentioning

confidence: 99%

“…WHO's 2008 estimated prevalence of high cholesterol in The Gambia was 17.9% in males, 21.9% in females and 19.9% for the total population [10]. Therefore as part of our study to determine the relationship between left ventricular hypertrophy and insulin resistance we measured TC, TG, and HDL in non-hypertensive and hypertensive Gambians who were seen at outpatient clinics [11] [12]. Our main objective for this current study was to determine the mean lipid level and the prevalence of lipid disorders including atherogenic dylipidaemia among patients attending outpatient clinics in Banjul, The Gambia.…”

Section: Introductionmentioning

confidence: 99%

Lipid Levels and Disorders in Hospital Attendants in Banjul, The Gambia

Nkum¹,

Micah²,

Ankrah³

et al. 2016

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Background: One of the major risk factors for cardiovascular diseases is lipid abnormalities. Objective: To determine the mean lipid levels and the prevalence of lipid disorders among patients attending outpatient clinics in Banjul, The Gambia. Design: Cross-sectional study. Setting: Outpatient clinics of Royal Edward Francis Small Teaching Hospital and Medical Research Council Laboratories in Banjul, The Gambia. Methods: Two hundred and eight consecutive patients with systemic hypertension on treatment and 108 non-hypertensive patients aged over 25 years were enrolled. A questionnaire was filled and anthropometric measurements were taken. An oral glucose tolerance test (OGTT) was done as well as blood investigations including total cholesterol (TC), high-density lipoprotein cholesterol (HDL) and triglycerides (TG). Low-density lipoprotein cholesterol (LDL) was calculated using the Friedwald formula. There were 305 participants with complete lipid results and these were included in the analysis. Results: The mean (standard deviation) TC was 4.92 (1.78) mmol/L; mean TG was 0.94 (0.56) mmol/L; mean HDL was 1.28 (0.48) mmol/L and mean LDL was 3.20 (1.41) mmol/L. The prevalence of lipid abnormalities was 41% for high TC, 9% for high TG, 36% for low HDL, 49% for high LDL and 6% for atherogenic dyslipidaemia. Conclusion: The mean lipid level and the prevalence of lipid disorders in patients attending clinics in Banjul were high.

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“…LVH initially occurs as a compensatory process that represents an adaptation to increased ventricular wall stress. Besides this raised BP, many other pathophysiological processes such as sympathetic overdrive [5] activation of the renin angiotensin aldosterone system (RAAS) [6], insulin resistance [7], tissue-related factors such as endothelins [8], genetic and racial predisposition [9] and levels of dietary salt intake [10] have all been implicated in the causation and progression of LVH in patients with HT.…”

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confidence: 99%