HYPERINSULINEMIA, REGIONAL ADIPOSE-TISSUE DISTRIBUTION AND LEFT-VENTRICULAR MASS IN NORMOTENSIVE, ELDERLY, OBESE SUBJECTS

Obesity is a metabolic condition, related to abnormalities of the glyc o-insulinaemic metabolism, and plays a substantial role in the develop ment of cardiovascular disease. The aim of this study was to establish a correlation among left ventricular mass? evaluated echocardiographi cally according to Penn Convention criteria, blood pressure, evaluated by ambulatory blood pressure monitoring, anthropometric indices for e valuation of body mass index and waist to hip ratio circumference, reg ional adipose tissue distribution, evaluated by ultrasound measurement s of visceral adipose tissue. and insulin resistance, evaluated by hyp erinsulinaemia by oral glucose tolerance test. We selected two groups of elderly male subjects well matched for age (68.5 +/- 6.4 years): 29 obese and 20 lean, with a body mass index, respectively, of 34.6 +/- 2.9 and 23.4 +/- 2.3. Statistical analysis was carried out by Student' s t-test and linear regression analysis. In spite of the fact that sta tistical analysis showed a higher, though not statistically significan t, systolic and diastolic mean blood pressure in the lean subjects, we found an increased left ventricular mass in obese subjects (P<0.0001) . The area under the insulin curve was higher in obese than in lean su bjects (P<0.0001) while the area under the glucose curve was not signi ficantly different in the two groups, Furthermore, linear regression a nalysis showed that in obese subjects left ventricular mass was strict ly correlated with visceral adipose tissue (r=0.607; P<0.0001) and hyp erinsulinaemia (r=0.615; P<0.0001). In conclusion, our data suggest th at centripetal adipose tissue distribution and hyperinsulinaemia, inde pendent of blood pressure values, are closely correlated with left ven tricular mass.