Impact of insulin resistance on subclinical left ventricular dysfunction in normal weight and overweight/obese japanese subjects in a general community
Abstract Background Insulin resistance carries increased risk of heart failure, although the pathophysiological mechanisms remain unclear. LV global longitudinal strain (LVGLS) assessed by speckle-tracking echocardiography has emerged as an important tool to detect early LV systolic abnormalities. T...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-01-01
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| Series: | Cardiovascular Diabetology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12933-020-01201-6 |
| _version_ | 1818456713703981056 |
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| author | Kazutoshi Hirose Koki Nakanishi Masao Daimon Naoko Sawada Yuriko Yoshida Kentaro Iwama Yuko Yamamoto Jumpei Ishiwata Megumi Hirokawa Katsuhiro Koyama Tomoko Nakao Hiroyuki Morita Marco R. Di Tullio Shunichi Homma Issei Komuro |
| author_facet | Kazutoshi Hirose Koki Nakanishi Masao Daimon Naoko Sawada Yuriko Yoshida Kentaro Iwama Yuko Yamamoto Jumpei Ishiwata Megumi Hirokawa Katsuhiro Koyama Tomoko Nakao Hiroyuki Morita Marco R. Di Tullio Shunichi Homma Issei Komuro |
| author_sort | Kazutoshi Hirose |
| collection | DOAJ |
| description | Abstract Background Insulin resistance carries increased risk of heart failure, although the pathophysiological mechanisms remain unclear. LV global longitudinal strain (LVGLS) assessed by speckle-tracking echocardiography has emerged as an important tool to detect early LV systolic abnormalities. This study aimed to investigate the association between insulin resistance and subclinical left ventricular (LV) dysfunction in a sample of the general population without overt cardiac disease. Methods We investigated 539 participants who voluntarily underwent extensive cardiovascular health check including laboratory test and speckle-tracking echocardiography. Glycemic profiles were categorized into 3 groups according to homeostatic model assessment of insulin resistance (HOMA-IR): absence of insulin resistance (HOMA-IR < 1.5), presence of insulin resistance (HOMA-IR ≥ 1.5) and diabetes mellitus (DM). Multivariable logistic regression models were conducted to evaluate the association between abnormal glucose metabolism and impaired LVGLS (> − 16.65%). Results Forty-five (8.3%) participants had DM and 66 (12.2%) had abnormal HOMA-IR. LV mass index and E/e′ ratio did not differ between participants with and without abnormal HOMA-IR, whereas abnormal HOMA-IR group had significantly decreased LVGLS (− 17.6 ± 2.6% vs. − 19.7 ± 3.1%, p < 0.05). The prevalence of impaired LVGLS was higher in abnormal HOMA-IR group compared with normal HOMA-IR group (42.4% vs. 14.0%) and similar to that of DM (48.9%). In multivariable analyses, glycemic abnormalities were significantly associated with impaired LVGLS, independent of traditional cardiovascular risk factors and pertinent laboratory and echocardiographic parameters [adjusted odds ratio (OR) 2.38, p = 0.007 for abnormal HOMA-IR; adjusted OR 3.02, p = 0.003 for DM]. The independent association persisted even after adjustment for waist circumference as a marker of abdominal adiposity. Sub-group analyses stratified by body mass index showed significant association between abnormal HOMA-IR and impaired LVGLS in normal weight individuals (adjusted OR 4.59, p = 0.001), but not in overweight/obese individuals (adjusted OR 1.62, p = 0.300). Conclusions In the general population without overt cardiac disease, insulin resistance carries independent risk for subclinical LV dysfunction, especially in normal weight individuals. |
| first_indexed | 2024-12-14T22:31:03Z |
| format | Article |
| id | doaj.art-60332b65a4c04b2ab60b703987703a68 |
| institution | Directory Open Access Journal |
| issn | 1475-2840 |
| language | English |
| last_indexed | 2024-12-14T22:31:03Z |
| publishDate | 2021-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Cardiovascular Diabetology |
| spelling | doaj.art-60332b65a4c04b2ab60b703987703a682022-12-21T22:45:15ZengBMCCardiovascular Diabetology1475-28402021-01-0120111110.1186/s12933-020-01201-6Impact of insulin resistance on subclinical left ventricular dysfunction in normal weight and overweight/obese japanese subjects in a general communityKazutoshi Hirose0Koki Nakanishi1Masao Daimon2Naoko Sawada3Yuriko Yoshida4Kentaro Iwama5Yuko Yamamoto6Jumpei Ishiwata7Megumi Hirokawa8Katsuhiro Koyama9Tomoko Nakao10Hiroyuki Morita11Marco R. Di Tullio12Shunichi Homma13Issei Komuro14Department of Cardiovascular Medicine, The University of TokyoDepartment of Cardiovascular Medicine, The University of TokyoDepartment of Cardiovascular Medicine, The University of TokyoDepartment of Cardiovascular Medicine, The University of TokyoDepartment of Cardiovascular Medicine, The University of TokyoDepartment of Cardiovascular Medicine, The University of TokyoDepartment of Cardiovascular Medicine, The University of TokyoDepartment of Cardiovascular Medicine, The University of TokyoDepartment of Cardiovascular Medicine, The University of TokyoDepartment of Cardiovascular Medicine, The University of TokyoDepartment of Cardiovascular Medicine, The University of TokyoDepartment of Cardiovascular Medicine, The University of TokyoDepartment of Medicine, Columbia UniversityDepartment of Medicine, Columbia UniversityDepartment of Cardiovascular Medicine, The University of TokyoAbstract Background Insulin resistance carries increased risk of heart failure, although the pathophysiological mechanisms remain unclear. LV global longitudinal strain (LVGLS) assessed by speckle-tracking echocardiography has emerged as an important tool to detect early LV systolic abnormalities. This study aimed to investigate the association between insulin resistance and subclinical left ventricular (LV) dysfunction in a sample of the general population without overt cardiac disease. Methods We investigated 539 participants who voluntarily underwent extensive cardiovascular health check including laboratory test and speckle-tracking echocardiography. Glycemic profiles were categorized into 3 groups according to homeostatic model assessment of insulin resistance (HOMA-IR): absence of insulin resistance (HOMA-IR < 1.5), presence of insulin resistance (HOMA-IR ≥ 1.5) and diabetes mellitus (DM). Multivariable logistic regression models were conducted to evaluate the association between abnormal glucose metabolism and impaired LVGLS (> − 16.65%). Results Forty-five (8.3%) participants had DM and 66 (12.2%) had abnormal HOMA-IR. LV mass index and E/e′ ratio did not differ between participants with and without abnormal HOMA-IR, whereas abnormal HOMA-IR group had significantly decreased LVGLS (− 17.6 ± 2.6% vs. − 19.7 ± 3.1%, p < 0.05). The prevalence of impaired LVGLS was higher in abnormal HOMA-IR group compared with normal HOMA-IR group (42.4% vs. 14.0%) and similar to that of DM (48.9%). In multivariable analyses, glycemic abnormalities were significantly associated with impaired LVGLS, independent of traditional cardiovascular risk factors and pertinent laboratory and echocardiographic parameters [adjusted odds ratio (OR) 2.38, p = 0.007 for abnormal HOMA-IR; adjusted OR 3.02, p = 0.003 for DM]. The independent association persisted even after adjustment for waist circumference as a marker of abdominal adiposity. Sub-group analyses stratified by body mass index showed significant association between abnormal HOMA-IR and impaired LVGLS in normal weight individuals (adjusted OR 4.59, p = 0.001), but not in overweight/obese individuals (adjusted OR 1.62, p = 0.300). Conclusions In the general population without overt cardiac disease, insulin resistance carries independent risk for subclinical LV dysfunction, especially in normal weight individuals.https://doi.org/10.1186/s12933-020-01201-6Insulin resistanceLeft ventricular global longitudinal strainSpeckle‐tracking echocardiography |
| spellingShingle | Kazutoshi Hirose Koki Nakanishi Masao Daimon Naoko Sawada Yuriko Yoshida Kentaro Iwama Yuko Yamamoto Jumpei Ishiwata Megumi Hirokawa Katsuhiro Koyama Tomoko Nakao Hiroyuki Morita Marco R. Di Tullio Shunichi Homma Issei Komuro Impact of insulin resistance on subclinical left ventricular dysfunction in normal weight and overweight/obese japanese subjects in a general community Cardiovascular Diabetology Insulin resistance Left ventricular global longitudinal strain Speckle‐tracking echocardiography |
| title | Impact of insulin resistance on subclinical left ventricular dysfunction in normal weight and overweight/obese japanese subjects in a general community |
| title_full | Impact of insulin resistance on subclinical left ventricular dysfunction in normal weight and overweight/obese japanese subjects in a general community |
| title_fullStr | Impact of insulin resistance on subclinical left ventricular dysfunction in normal weight and overweight/obese japanese subjects in a general community |
| title_full_unstemmed | Impact of insulin resistance on subclinical left ventricular dysfunction in normal weight and overweight/obese japanese subjects in a general community |
| title_short | Impact of insulin resistance on subclinical left ventricular dysfunction in normal weight and overweight/obese japanese subjects in a general community |
| title_sort | impact of insulin resistance on subclinical left ventricular dysfunction in normal weight and overweight obese japanese subjects in a general community |
| topic | Insulin resistance Left ventricular global longitudinal strain Speckle‐tracking echocardiography |
| url | https://doi.org/10.1186/s12933-020-01201-6 |
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