Author/Editor		Žemva, A; Marn-Pernat, A; Jelenc, M; Žemva, Ž
Title		Is diastolic dysfunction related to insulin resistance?
Type		članek
Source		In: Ashton-Miller JA, editor. Proceedings of the 10th international conference on mechanics in medicine and biology; 1998 Mar 2-5; Waikiki, Honolulu. Waikiki: Pacific centre of thermal-fluids engineering (PCTFE),
Publication year		1998
Volume		str. 279-82
Language		eng
Abstract		To investigate the relationship of insulin metabolism to diastolic function, 41 patients with borderline and mild hypertension and 24 healthy subjects were included in the study. They underwent a 75-g oral glucose tolerance test. Blood samples were obtained at the beginning of the test and 30, 60 and 120 minutes the reafter for determination of glucose and insulin concentration. Integrated response of insulin to the glucose load was calculated as the area under the curve of insulin (AUC-I) and glucose (AUC-G). The ratio AUC-I/AUC-G was taken as an index of insulin sensitivity (resistance). The reafter echocardiographic examination was performed. Left ventricular mass was determined by Devereux formula and diastolic function assessed by pulsed Doppler technique. The ratio of early to late transmitral peak velocity (E/A) ratio was used as an index of left ventricular diastolic filling. The hypertensive men were older and had higher body mas index and systolic and diastolic pressure. The hypertensives had higher fasting insulin (14 +- 6 vs 9 +- 2; P < 0.001) as well as insulin levels at 60 minutes (86 +- 39 vs 46 +- 20; P < 0.001) and at 120 minute (54 +- vs 26 +- 13; P < 0.01) after oral glucoe load. They had higher AUC-I (7615 +- 3615 vs 4542 +- 1369: P < 0.001) and lower insulin sensitivity index (7.6 +- 3.1 vs 6.1 +- 1.5; P = 0.06) compared to normontensives. Hypertensive patients had lower E/A ratio than normotensive volunteers (1.2 +- 0.3 vs 1.5 +- 0.3, P < 0.01). In all subjects, the E/A ratio was negatively correlated with fasting insulin (r = - 0.24, P = 0.05) and insulin concentrations at 30 minutes (r = -0.30, P < 0.05), at 60 minutes (r = -0.54, P < 0.001) and at 120 minutes (r = -0.35, P < 0.01), AUC-I (r = -0.48, P < 0.001) and insulin sensitivity index (r + -0.40, P < 0.01). (Abstract truncated at 2000 characters).
Descriptors		HYPERTENSION HEART DISEASES DIASTOLE BLOOD PRESSURE VENTRICULAR DYSFUNCTION, LEFT INSULIN RESISTANCE GLUCOSE TOLERANCE TEST HYPERINSULINEMIA HEART RATE METABOLISM VENTRICULAR FUNCTION, LEFT RADIOIMMUNOASSAY ECHOCARDIOGRAPHY, DOPPLER, PULSED BLOOD FLOW VELOCITY