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Journals / MN Kardiyoloji / 2004 / Cilt: 11 - Sayı: 5

Relation of HOMA index and left ventricular function and structure with essential hypertension

Esansiyel hipertansiyonlu hastalarda HOMA indeksi ile sol ventrikül fonksiyonu ve yapısının ilişkisi

Harun EVRENGÜL
Mustafa ZUNGUR
DURSUN DURSUNOĞLU
Asuman KAFTAN
Halil TANRIVERDİ
Mustafa KILIÇ
Pages
363–369
DOI
—
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AI Summary & Key Takeaways

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⚡ TL;DR(Too Long; Didn't Read)

Conclusions: These results demonstrated that hypertensive patients had both abnormal cardiac structure and function and higher HOMA index.

📌 3 Key Takeaways

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Objective & Hypothesis:Aim: The purpose of this study was to examine the relationship between left ventricular structure, function and HOMA index in patients with EH.
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Key Findings & Data:Material and Methods: We enrolled 73 patients (21 men, mean age 51.7±9.2 years) with untreated hypertension (BP>140 and/or 90 mmHg, fasting glycemia <110 mg/dl) and 64 healthy subjects without diabetes mellitus and hypertension (21 men, mean age 48.9±10.6 years) constituted the control group.
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Conclusion & Impact:Conclusions: These results demonstrated that hypertensive patients had both abnormal cardiac structure and function and higher HOMA index.
🔬Design:Modeling & Simulation
📍Scope:Comprehensive Sample
⚙️Variables:Hipertansiyon · Hipertrofi · sol ventrikül

Abstract

Aim: The purpose of this study was to examine the relationship between left ventricular structure, function and HOMA index in patients with EH. Material and Methods: We enrolled 73 patients (21 men, mean age 51.7±9.2 years) with untreated hypertension (BP>140 and/or 90 mmHg, fasting glycemia <110 mg/dl) and 64 healthy subjects without diabetes mellitus and hypertension (21 men, mean age 48.9±10.6 years) constituted the control group. In all subjects, transthoracic echocardiography was performed and blood samples were taken. Homeostasis model assessment (HOMA) was calculated by the formula: HOMA-index=Fasting blood glucose (mg/dl). *Immunoreactive insulin (µU/ml)/405 for the assessment of IR. Hypertensive patients were divided in two groups by mean HOMA index values. Each subject was examined for LV end-diastolic diameter, septal and posterior wall thickness, LV mass index (LVMI), fractional shortening (FS), mitral inflow velocity pattern, atrial filling fraction (AFF), left ventricular outflow velocity pattern and the total ejection isovolume index (TEI index). Results: The HOMA index (p<0.001), LVMI (p<0.001), AFF (p<0.0001), peak A velocity (p<0.028), septal (p<0.0001) and posterior (p<0.0001) wall thickness were significantly higher and FS (p<0.001), E/A ratio (p<0.0001) were significantly lower in hypertensive patients than healthy controls. LVMI (p<0.01) and septal wall thickness (p<0.001) were significantly higher in those hypertensive patients with higher HOMA index. HOMA-index was univariately related to TEI index (r=0.27, p=0.01) and septal wall thickness (IVS) (r=0.29, p=0.01) by Pearson correlation analysis in hypertensive patients. Conclusions: These results demonstrated that hypertensive patients had both abnormal cardiac structure and function and higher HOMA index. In our study group, the effect of hypertension on cardiac structure and function was correlated with HOMA index. Our results suggested that IR might be an important factor causing left ventricular dysfunction and wall increased thickness in non-diabetic patients with EH.

Özet

Amaç: Bu çalışmanın amacı, EH'li hastalarda sol ventrikül yapısı, fonksiyonu ve HOMA indeksi arasındaki ilişkiyi incelemektir. Gereç ve Yöntem: Tedavi edilmemiş hipertansiyonu bulunan 73 hasta (21 erkek, ortalama yaş 51.7±9.2) çalışmaya dahil edildi ve kontrol grubu olarak 64 sağlıklı olgu (21 erkek, ortalama yaş 48.9±10.6) seçildi. Tüm olgulara transtorasik ekokardiyografi yapıldı. İnsülin rezistans indeksi için HOMA-indeksi (Homeostasis model assessment) kullanıldı. HOMA-indeksi şu formülle hesaplandı: HOMA-indeksi=Açlık Kan Şekeri (mg/dl) *İmmünoreaktif insülin (µU/ml)/405. Hipertansif hastalar, ortalama HOMA indeksi değerlerine göre iki gruba ayrıldı. Her bir denek LV diyastol sonu çap, septal (İVS) ve posterior duvar kalınlığı, sol ventrikül kütle indeksi (SVKİ), fraksiyonel kısalma (FS), mitral inflow hız paterni, atriyal dolum fraksiyonu (AFF), sol ventrikül outflow hız paterni ve total ejeksiyon izovolüm indeksi (TEI indeksi) açısından incelendi. Bulgular: HOMA indeksi (p<0.001), SVKİ (p<0.001), AFF (p<0.0001), tepe A hızı (p<0.028), septal (p<0.0001) ve posterior (p<0.0001) duvar kalınlıkları hipertansif hastalarda kontrollere göre anlamlı şekilde daha yüksekti ve FS (p<0.001), E/A oranı (p<0.0001) anlamlı şekilde daha düşüktü. SVKİ (p<0.01) ve septal duvar kalınlığı (p<0.001), daha yüksek HOMA indeksi bulunan hipertansif hastalarda anlamlı şekilde daha büyüktü. Hipertansif hastalarda Pearson korelasyon analizi ile HOMA-indeksi, TEI indeksi (r=0.27, p=0.01) ve IVS (r=0.29, p=0.01) arasında anlamlı ilişki saptandı. SVKİ, FS ve mitral inflow hız paterni, HOMA indeksi ile ilişkili değildi. HOMA-indeksi stepwise regresyon analizinde bağımsız değişken olarak TEI indeksi (R2=0.20, p=0.0001) ve IVS (R2=0.12, p=0.002), ile anlamlı şekilde ilişkili bulundu. Sonuç: Hipertansif hastalarda hem anormal kalp yapısı ve fonksiyonu hem de daha yüksek HOMA indeksi bulunur. Kalp yapısı ve fonksiyonları üzerine hipertansiyonun etkisi HOMA indeksi ile koreledir. IR; EH'li non-diyabetik hastalarda sol ventrikül disfonksiyonuna ve duvar kalınlaşmasına sebep olan önemli bir faktör olabilir.

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Cite This Article

EVRENGÜL, H., ZUNGUR, M., DURSUNOĞLU, D., KAFTAN, A., TANRIVERDİ, H., KILIÇ, M. (2004). Relation of HOMA index and left ventricular function and structure with essential hypertension. MN Kardiyoloji, Cilt: 11 - Sayı: 5, 363–369. https://ajindex.com/articles/297629

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