Copyright © 1998 by the European Society of Cardiology.
Hyperinsulinaemia, regional adipose tissue distribution and left ventricular mass in normotensive, elderly, obese subjects
Cattedra di Geriatria, Istituto I Clinica Medica, Università La Sapienza Rome, Italy
accepted July 10, 1997
Obesity is a metabolic condition, related to abnormalities of the glyco-insulinaemic metabolism, and plays a substantial role in the development of cardiovascular disease. The aim of this study was to establish a correlation among left ventricular mass, evaluated echocardiographically according to Penn Convention criteria, blood pressure, evaluated by ambulatory blood pressure monitoring, anthropometric indices for evaluation of body mass index and waist to hip ratio circumference, regional adipose tissue distribution, evaluated by ultrasound measurements of visceral adipose tissue, and insulin resistance, evaluated by hyperinsulin-aemia by oral glucose tolerance test.
We selected two groups of elderly male subjects well matched for age (68·5±6·4 years): 29 obese and 20 lean, with a body mass index, respectively, of 34·6±2·9 and 23·4±2·3. Statistical analysis was carried out by Students t-test and linear regression analysis. In spite of the fact that statistical analysis showed a higher, though not statistically significant, systolic and diastolic mean blood pressure in the lean subjects, we found an increased left ventricular mass in obese subjects (P<0·0001). The area under the insulin curve was higher in obese than in lean subjects (P<0·0001) while the area under the glucose curve was not significantly different in the two groups. Furthermore, linear regression analysis showed that in obese subjects left ventricular mass was strictly correlated with visceral adipose tissue (r=0·607;P<0·0001) and hyperinsulinaemia (r=0·615;P<0·0001).
In conclusion, our data suggest that centripetal adipose tissue distribution and hyperinsulinaemia, independent of blood pressure values, are closely correlated with left ventricular mass.
Key Words: Left ventricular mass obesity hyperinsulinaemia ambulatory blood pressure ageing
f1 Correspondence: Dr Francesco Vetta, MD, Cattedra di Geriatria, I Clinica Medica, Università La Sapienza, via Emilio De Marchi 81, 00141 Rome, Italy.
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