Association between insulin resistance and left ventricular hypertrophy in sub-saharan hypertensive black patients with preserved ejection fraction: A case control study

Abstract Background:Conflicting information exists regarding the association between insulin resistance (IR) and left ventricular hypertrophy (LVH).We described the associations between parameters of obesity, fasting insulinemia, HOMAIR with LVH in black patients with essential hypertension.Materials and Methods:A case-control study was conducted at the Centre Médical de Kinshasa (CMK), the Democratic Republic of the Congo, between January and December 2019. Cases and controls were hypertensive patients with and without LVH, respectively. The relationship between obesity indices, physical inactivity, parameters of glucose metabolisme and lipid disorders and LVH were assessed using linear and logistic regression analyses in simple and univariate exploratory analysis, respectively. When differences were observed between LVH and the independent variables, the effect of potential confounders was studied by adjustment in multiple linear regression and in conditional logistic regression in multivariate analysis. The coefficients of determinations (R2), the adjusted ORs and their 95% CI were calculated to determine the association between the LVH and the independent variablesResults:Eighty-eight cases (52 men) were compared to 132 controls (81 men). Nineteen percent of left ventricular mass (LVM) variation (19%) was predicted by age, 31.3% by the duration of hypertension, 44.4% by BMI, 42.5% by WC, 20% by glycemia, 44.8% by insulinemia and 43.7% by HOMAIR. In multiple linear regression analysis, duration of hypertension, Body Mass Index (BMI), insulinemia and HOMAIR explained 68.3% of the variability in the increase in LVM. In the logisitic model obesity multiplied the risk of LVH by 3 (aOR: 2.8, 95% CI (1.06-7.4), p = 0.038), IR by 8 (aOR: 8.4, 95: (3.7-15.7), p <0.001).Conclusion:Obesity and IR appear to be the main predictors of LVH. The comprehensive management of cardiovascular risk factors should be emphasized with particular attention to obesity and insulin resistance. A prospective black sub-saharan population based study with serial imaging remain essential to better understand subclinical LV deterioration over time and to confirm the role of insulin resistance in black sub-saharan hypertensives.

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Association between insulin resistance and left ventricular hypertrophy in sub-saharan hypertensive black patients with preserved ejection fraction: A case control study

10.21203/rs.3.rs-33818/v1 ◽

2020 ◽

Author(s):

Bernard KIANU PHANZU ◽

Nkodila Natuhoyila Aliocha ◽

Kintoki Vita Eleuthère ◽

M’Buyamba Kabangu Jean-René ◽

Longo-Mbenza Benjamin

Keyword(s):

Insulin Resistance ◽

Logistic Regression ◽

Ventricular Hypertrophy ◽

Case Control Study ◽

Case Control ◽

Left Ventricular ◽

Independent Variables ◽

Black Patients ◽

Sub Saharan ◽

Control Study

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Association between insulin resistance and left ventricular hypertrophy in asymptomatic, Black, sub-Saharan African, hypertensive patients: a case–control study

BMC Cardiovascular Disorders ◽

10.1186/s12872-020-01829-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Bernard Kianu Phanzu ◽

Aliocha Nkodila Natuhoyila ◽

Eleuthère Kintoki Vita ◽

Jean-René M’Buyamba Kabangu ◽

Benjamin Longo-Mbenza

Keyword(s):

Insulin Resistance ◽

Logistic Regression ◽

Ventricular Hypertrophy ◽

Case Control Study ◽

Case Control ◽

Left Ventricular ◽

Hypertensive Patients ◽

Independent Variables ◽

Sub Saharan ◽

Control Study

Abstract Background Conflicting information exists regarding the association between insulin resistance (IR) and left ventricular hypertrophy (LVH). We described the associations between obesity, fasting insulinemia, homeostasis model assessment of insulin resistance (HOMA-IR), and LVH in Black patients with essential hypertension. Methods A case–control study was conducted at the Centre Médical de Kinshasa (CMK), the Democratic Republic of the Congo, between January and December 2019. Cases and controls were hypertensive patients with and without LVH, respectively. The relationships between obesity indices, physical inactivity, glucose metabolism and lipid disorder parameters, and LVH were assessed using linear and logistic regression analyses in simple and univariate exploratory analyses, respectively. When differences were observed between LVH and independent variables, the effects of potential confounders were studied through the use of multiple linear regression and in conditional logistic regression in multivariate analyses. The coefficients of determination (R2), adjusted odds ratios (aORs), and their 95% confidence intervals (95% CIs) were calculated to determine associations between LVH and the independent variables. Results Eighty-eight LVH cases (52 men) were compared against 132 controls (81 men). Variation in left ventricular mass (LVM) could be predicted by the following variables: age (19%), duration of hypertension (31.3%), body mass index (BMI, 44.4%), waist circumference (WC, 42.5%), glycemia (20%), insulinemia (44.8%), and HOMA-IR (43.7%). Hypertension duration, BMI, insulinemia, and HOMA-IR explained 68.3% of LVM variability in the multiple linear regression analysis. In the logistic regression model, obesity increased the risk of LVH by threefold [aOR 2.8; 95% CI (1.06–7.4); p = 0.038], and IR increased the risk of LVH by eightfold [aOR 8.4; 95 (3.7–15.7); p < 0.001]. Conclusion Obesity and IR appear to be the primary predictors of LVH in Black sub-Saharan African hypertensive patients. The comprehensive management of cardiovascular risk factors should be emphasized, with particular attention paid to obesity and IR. A prospective population-based study of Black sub-Saharan individuals that includes the use of serial imaging remains essential to better understand subclinical LV deterioration over time and to confirm the role played by IR in Black sub-Saharan individuals with hypertension.

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Association between insulin resistance and left ventricular hypertrophy in asymptomatic Black sub-Saharan African hypertensive patients: A case-control study

10.21203/rs.3.rs-33818/v3 ◽

2020 ◽

Author(s):

Bernard KIANU PHANZU ◽

Nkodila Natuhoyila Aliocha ◽

Kintoki Vita Eleuthère ◽

M’Buyamba Kabangu Jean-René ◽

Longo-Mbenza Benjamin

Keyword(s):

Insulin Resistance ◽

Logistic Regression ◽

Ventricular Hypertrophy ◽

Case Control Study ◽

Case Control ◽

Left Ventricular ◽

Hypertensive Patients ◽

Independent Variables ◽

Sub Saharan ◽

Control Study

Abstract Background: Conflicting information exists regarding the association between insulin resistance (IR) and left ventricular hypertrophy (LVH).We described the associations between obesity, fasting insulinemia, homeostasis model assessment of insulin resistance (HOMA-IR), and LVH in Black patients with essential hypertension.Methods: A case-control study was conducted at the Centre Médical de Kinshasa (CMK), the Democratic Republic of the Congo, between January and December 2019. Cases and controls were hypertensive patients with and without LVH, respectively. The relationships between obesity indices, physical inactivity, glucose metabolism and lipid disorder parameters, and LVH were assessed using linear and logistic regression analyses in simple and univariate exploratory analyses, respectively. When differences were observed between LVH and independent variables, the effects of potential confounders were studied through the use of multiple linear regression and in conditional logistic regression in multivariate analyses. The coefficients of determination (R2), adjusted odds ratios (aORs), and their 95% confidence intervals (95% CIs) were calculated to determine associations between LVH and the independent variables.Results: Eighty-eight LVH cases (52 men) were compared against 132 controls (81 men). Variation in left ventricular mass (LVM) could be predicted by the following variables: age (19%), duration of hypertension (31.3%), body mass index (BMI, 44.4%), waist circumference (WC, 42.5%), glycemia (20%), insulinemia (44.8%), and HOMA-IR (43.7%). Hypertension duration, BMI, insulinemia, and HOMA-IR explained 68.3% of LVM variability in the multiple linear regression analysis. In the logistic regression model, obesity increased the risk of LVH by 3-fold [aOR: 2.8; 95% CI (1.06–7.4); p = 0.038], and IR increased the risk of LVH by 8-fold [aOR: 8.4; 95: (3.7–15.7); p < 0.001].Conclusion: Obesity and IR appear to be the primary predictors of LVH in Black sub-Saharan African hypertensive patients. The comprehensive management of cardiovascular risk factors should be emphasized, with particular attention paid to obesity and IR. A prospective population-based study of Black sub-Saharan individuals that includes the use of serial imaging remains essential to better understand subclinical LV deterioration over time and to confirm the role played by IR in Black sub-Saharan individuals with hypertension.

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Association between insulin resistance and left ventricular hypertrophy in asymptomatic Black sub-Saharan African hypertensive patients: A case-control study

10.21203/rs.3.rs-33818/v2 ◽

2020 ◽

Author(s):

Bernard KIANU PHANZU ◽

Nkodila Natuhoyila Aliocha ◽

Kintoki Vita Eleuthère ◽

M’Buyamba Kabangu Jean-René ◽

Longo-Mbenza Benjamin

Keyword(s):

Insulin Resistance ◽

Logistic Regression ◽

Ventricular Hypertrophy ◽

Case Control Study ◽

Case Control ◽

Left Ventricular ◽

Hypertensive Patients ◽

Independent Variables ◽

Sub Saharan ◽

Control Study

Abstract Background: Conflicting information exists regarding the association between insulin resistance (IR) and left ventricular hypertrophy (LVH). Here, we described the associations between parameters of obesity, fasting insulinaemia, homeostasis model assessment of insulin resistance (HOMA-IR) and LVH in Black patients with essential hypertension. Methods: A case-control study was conducted at the Centre Médical de Kinshasa (CMK), the Democratic Republic of the Congo, between January and December 2019. Cases and controls were hypertensive patients with and without LVH, respectively. The relationships between obesity indices, physical inactivity, parameters of glucose metabolism and lipid disorders and LVH were assessed using linear and logistic regression analyses in simple and univariate exploratory analyses, respectively. When differences were observed between LVH and the independent variables, the effect of potential confounders was studied by adjustment in multiple linear regression and conditional logistic regression in multivariate analysis. The coefficients of determination (R2), the adjusted ORs and their 95% CIs were calculated to determine the association between LVH and the independent variables. Results: Eighty-eight cases (52 men) were compared to 132 controls (81 men). Nineteen percent (19%) of left ventricular mass (LVM) variation was predicted by age; 31.3%, by the duration of hypertension; 44.4%, by body mass index (BMI); 42.5%, by waist circumference (WC); 20%, by glycaemia; 44.8%, by insulinaemia; and 43.7%, by HOMA-IR. In multiple linear regression analysis, duration of hypertension, BMI, insulinaemia and HOMA-IR explained 68.3% of the variability in the increase in LVM. In the logistic model, obesity multiplied the risk of LVH by 3 (aOR: 2.8, 95% CI (1.06-7.4), p = 0.038) and IR by 8 (aOR: 8.4, 95: (3.7-15.7), p <0.001). Conclusions: Obesity and IR appear to be the main predictors of LVH in Black sub-Saharan African hypertensive patients. The comprehensive management of cardiovascular risk factors should be emphasized with particular attention to obesity and IR. A prospective Black sub-Saharan population-based study with serial imaging remains essential to better understand subclinical LV deterioration over time and to confirm the role of IR in Black sub-Saharan individuals with hypertension.

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