ABSTRACT

Obesity is correlated with left ventricular mass (LVM) and insulin resistance (IR) and is an independent predictor of LVM in nondiabetic, non-hypertensive, 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.

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.

The mean age was 39.3±11.2 years and the mean BMI was 39.5±5.7 kg/m² in the obese group; the mean age was 38.4±9.5 years and the mean BMI was 22.5±1.9 kg/m2 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 associated with LWM, LWMI, aortic diameter (AD), left atrial diameter (LAD), interventricular wall thickness (IVWT), left ventricular end diastolic diameter (IVEDD), and left ventricular posterior wall thickness (LVPWT). Age, insulin value, and BMI were determinants of LVMI (p<0.001 for age and BMI, p=0.003 for insulin). IR was negatively correlated with left ventricular systolic function. AD, LAD, IVWT, LVEDD, and LVPWT were higher in the obese subjects than in the controls.

Although left ventricular structural abnormalities were found, we did not observe diastolic dysfunction. Although systolic and diastolic functions were within normal limits, both functions were impaired in the obese group compared to normal subjects. This finding may indicate myocardial involvement in obesity. We observed that obesity is associated with LVM independently from hypertension and diabetes mellitus.

Keywords: Obesity, left ventricular mass, insulin resistance