Relationship of Left Ventricular Mass with BMI and Insulin Resistance in Normotensive Obese Women

Abstract

The relationship between excess body weight and cardiovascular disease has been well known for years (1)(2)(3)(4)(5). Increasing body mass requires increased cardiac debi and vascular volume to supply metabolic demands (3,6,7). This may be partly due to the altered metabolic needs induced by increased body weight (8).Left ventricular hypertrophy (LVH) may cause diastolic and systolic heart failure; it is also an independent risk factor for cardiac arrhythmia, sudden death, myocardial ischemia, and heart failure (9). LVH in obese people is related to the severity of comorbidities, mainly hypertension. Although obesity itself is an independent risk factor for LVH in hypertensive patients, the roles of excess body weight and obesity in LVH in normotensive subjects are inconclusive (5, 10). In this article, we investigated the relationships of obesity and insulin resistance with LVH and diastolic function in nondiabetic, normotensive women who were followed up at our obesity outpatient clinic; the results were compared with those of normal women. MethodsThis study was conducted at our hospital with 81 obese, nondiabetic, normotensive female subjects (study group) and 36 healthy female controls (control group). All participants were informed about the survey and freely signed and dated the consent form. The protocol was approved by the Local Ethics Committee and was conducted in accordance with the Declaration of Helsinki.Patients were excluded if they had a history of ischemic heart disease, congestive heart failure, cardiac valve disease, liver or kidney disease, hypertension, cancer, adrenal disease (such as Conn's disease, pheochromocytoma, or Cushing's syndrome, which can cause secondary hypertension), diabetes mellitus, thyroid disease, glucose intolerance, malnutrition, or malabsorption.The age, weight, height, body mass index (BMI), waist circumference (WC), systolic and diastolic blood pressure, and heart rate of the subjects were recorded. Serum fasting blood glucose (FBG), Relationship of Left Ventricular Mass with BMI and Insulin Resistance in Normotensive Obese WomenObjective: Obesity is correlated with left ventricular mass (LVM) and insulin resistance (IR) and is an independent predictor of LVM in nondiabetic, nonhypertensive, obese people. Our aim was to investigate the relationship of body mass index (BMI) and IR with left venticular mass index (LVMI) in obese and nonobese, normotensive, nondiabetic women.Methods: 81 obese, normotensive, nondiabetic women and 36 healthy women of normal weight were included in the study. We compared the demographic features, biochemical values, insulin and HOMA-IR values, heart rate, blood pressure, and echocardiographic parameters of the obese and nonobese subjects. Results:The mean age was 39.3±11.2 years and the mean BMI was 39.5±5.7 kg/m 2 in the obese group; the mean age was 38.4±9.5 years and the mean BMI was 22.5±1.9 kg/m 2 in the control group. Hyperinsulinemia (19.3±10.4 µU/mL) and IR (HOMA-IR: 4.6±2.9) were correlated with obesity. Insulin levels and IR were...