TY - JOUR
T1 - Insulin resistance and beat-to-beat cardiovascular dynamics
T2 - A constant relationship across different body mass index and blood pressure categories
AU - Ochoa, Juan Eugenio
AU - Gallo, Jaime Alberto
AU - Correa, Mónica Maria
AU - Zapata, Nora
AU - McEwen, Juan Guillermo
AU - Bilo, Grzegorz
AU - Aristizabal, Dagnovar
AU - Parati, Gianfranco
PY - 2015/2/1
Y1 - 2015/2/1
N2 - Context: Epidemiological studies have shown a progressive increase in insulin resistance (IR) accompanying body weight gain and blood pressure (BP) increase. This has led to the consideration that hemodynamic effects of IR might depend on its relationship with body mass index (BMI) and BP. Objective: The aim of our study was to determine whether IR is associated with changes in hemodynamic indices of cardiovascular function across different categories of BMI (normal weight, overweight, and obese), and BP levels (normal, high normal, and hypertension). Design, Setting and Participants: This was a cross-sectional study conducted in a population sample of nondiabetic individuals (n = 731). Measures: Insulin resistance was evaluated with the homeostasis model assessment of insulin resistance (HOMA) and subjects were classified into quartiles according to HOMA index values. Synchronized beat-to-beat recordings of stroke volume (impedance cardiography) and R-R interval, along with repeated auscultatory BP measurements were performed. Derived hemodynamic parameters were computed and averaged. Results: Analysis of covariance adjusting for confounders showed significant differences for most hemodynamic parameters among different quartiles of HOMA index both in the general population and within each BMI and BP category. Overall, increasing values of HOMA index were associated with significantly higher BP; and reduced R-R interval, stroke index, cardiac index, pre-ejection period and left ventricular ejection time (P <.01) across different categories of BMI and BP. Conclusions: These findings suggest that even small increases in HOMA index (not necessarily in the range to define IR) may induce significant changes on indices of cardiovascular function even in normal-weight and normotensive subjects, emphasizing the importance of IR at an early stage of the cardiovascular risk continuum.
AB - Context: Epidemiological studies have shown a progressive increase in insulin resistance (IR) accompanying body weight gain and blood pressure (BP) increase. This has led to the consideration that hemodynamic effects of IR might depend on its relationship with body mass index (BMI) and BP. Objective: The aim of our study was to determine whether IR is associated with changes in hemodynamic indices of cardiovascular function across different categories of BMI (normal weight, overweight, and obese), and BP levels (normal, high normal, and hypertension). Design, Setting and Participants: This was a cross-sectional study conducted in a population sample of nondiabetic individuals (n = 731). Measures: Insulin resistance was evaluated with the homeostasis model assessment of insulin resistance (HOMA) and subjects were classified into quartiles according to HOMA index values. Synchronized beat-to-beat recordings of stroke volume (impedance cardiography) and R-R interval, along with repeated auscultatory BP measurements were performed. Derived hemodynamic parameters were computed and averaged. Results: Analysis of covariance adjusting for confounders showed significant differences for most hemodynamic parameters among different quartiles of HOMA index both in the general population and within each BMI and BP category. Overall, increasing values of HOMA index were associated with significantly higher BP; and reduced R-R interval, stroke index, cardiac index, pre-ejection period and left ventricular ejection time (P <.01) across different categories of BMI and BP. Conclusions: These findings suggest that even small increases in HOMA index (not necessarily in the range to define IR) may induce significant changes on indices of cardiovascular function even in normal-weight and normotensive subjects, emphasizing the importance of IR at an early stage of the cardiovascular risk continuum.
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U2 - 10.1210/jc.2014-1799
DO - 10.1210/jc.2014-1799
M3 - Article
C2 - 25329765
AN - SCOPUS:84922513939
SN - 0021-972X
VL - 100
SP - 569
EP - 577
JO - Journal of Clinical Endocrinology and Metabolism
JF - Journal of Clinical Endocrinology and Metabolism
IS - 2
ER -