Relationship between plasma insulin and left ventricular mass in normotensive participants of the Gubbio Study

Summary background There is substantial but not conclusive evidence that insulin resistance is related to left ventricular mass (LVM) in hypertensive individuals. To what extent this association is mediated by the relationship between plasma insulin and body size and build is still debated, and is poorly explored in nonhypertensive people. objective To explore the relationship between insulin or insulin resistance and LVM in a population-based sample of nonhypertensive participants of the Gubbio Study. method Echocardiographic LVM was determined in 91 nondiabetic, nonhypertensive individuals aged 45–54 years, participating in a population-based screening. LVM normalized for height2·7 was used in the analyses; LV hypertrophy was defined as a value of ≥ 50 g/m2·7 in men or ≥ 47 g/m2·7 in women. Fasting plasma insulin and glucose were measured and the Homeostasis Model Assessment (HOMA) index was used as a measure of insulin resistance. results LVM was positively and significantly correlated with body mass index (BMI) (P < 0·01), waist circumference (P < 0·01) and HOMA index (P < 0·05), whereas correlations with plasma glucose and triglycerides did not reach statistical significance (P = 0·07 for both); all correlations were offset after adjusting for BMI. Fasting plasma insulin and HOMA index were not significantly different in subjects with or without LV hypertrophy (70·8 ± 27·8 vs. 77·7 ± 29·6 pmol/l and 2·2 ± 1·0 vs. 2·6 ± 1·4, respectively). Bivariate analysis performed stratifying participants above or below the 75th percentile of the sex-specific distribution for BMI (29·1 and 29·4 kg/m2 for males and females, respectively) and plasma insulin (84 pmol/l for either gender), did not result in appreciable differences in LVM due to insulin levels. Similar results were obtained replacing the HOMA index for insulin in the analysis. conclusion In nonhypertensive individuals left ventricular mass is not associated with plasma insulin independently of body mass index.