Insulin resistance, subclinical left ventricular remodeling, and the obesity paradox: the multi-ethnic study of atherosclerosis

2013 
Background Recent studies suggest that central obesity and insulin resistance may be primary mediators of obesity-related cardiac remodeling independent of body mass index (BMI). We assessed in the Multi-Ethnic Study of Atherosclerosis (MESA) whether insulin resistance and waist-to-hip ratio had effects on cardiac remodeling, independent of obesity. Methods We investigated 4,364 individuals without diabetes in MESA. Insulin resistance (by impaired fasting glucose, IFG: 100-125 mg/dl or homeostatic model assessment of insulin resistance, HOMA-IR) and waist-to-hip ratio (WHR) were used for cardiometabolic phenotyping. Multivariate linear regression analysis was used to determine
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