Author/Editor     Žemva, Aleš; Marn-Pernat, Andreja; Jelenc, Marjetka; Žemva, Žarka
Title     Diastolic function and insulin resistance in essential hypertension
Type     članek
Source     Int J Cardiol
Vol. and No.     Letnik 66
Publication year     1998
Volume     str. 293-7
Language     eng
Abstract     We studied the relationship of insulin metabolism to diastolic function in 41 hypertensive patients and 24 healthy subjects. They underwent a 75-g oral glucose tolerance test. Integrated response of insulin to the glucose load was calculated as the area under thc cun'r of insulin (AUC-I) and glucose (AUC-G). The ratio AUC-1/AUC-G was taken as an index ot insulin resistance. Echocardiographic examination was performed to measure left ventricular mass. We used pulsed Doppler technique to assess the ratio nf early to Iate transmitral peak velocity (E/A). The hypertensives had higher fasting insulin concentrations, insulin levels at 60 min and at 120 min after oral glucose load. They had higher AUC-I and higher index of insulin resistance compared to normotensives. Patients with hypertenlii,n had a lower E/A ratio in comparison to normotensive volunteers. In all subjects, the E/A ratio was negatively correlated with fasting insulin and insulin concentrations at 30, at 60 and at 120 min, AUC-I and insulin resistance index. Multiple regression analysis was performed to evaluate the above relationships, when the effects of confounding factors such as age, heart rate and systolic blood pressure were taken into account. We found that E/A ratio is negatively correlated to insulin concentrations at I20 min and to AUC-I in hyperinsulinemic subgroup of subjects (fasting insulin>10). We conclude, that insulin metabolism and E/A ratio, which reflects diastolic tunction of the left ventricle, are related in hypertension.
Descriptors     HYPERTENSION
INSULIN RESISTANCE
DIASTOLE
HYPERINSULINEMIA
ECHOCARDIOGRAPHY
REGRESSION ANALYSIS
INSULIN
GLUCOSE TOLERANCE TEST