P4.16 INSULIN RESISTANCE IS ASSOCIATED WITH INCREASED LARGE ARTERY STIFFNESS IN NORMOTENSIVE HEALTHY ADULTS
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Aim: At present there is limited evidence on the relationship between insulin resistance (IR) and measures of large artery stiffness (AS) and wave reflections in normotensive healthy adults. Aim of the present study was to explore this issue in 90 normotensive (Systolic(S) blood pressure(BP) 107.1±9.3; diastolic (D) BP 69.6±7.7 mmHg), normoglycemic, non-obese, otherwise healthy adults (mean age 48 ± 10 yrs, 50% female).
Methods: IR was assessed with HOMA-Index and subjects were classified into IR tertiles, based on the distribution of HOMA-index values. Recordings of pulse waveform were obtained by means of a validated oscillometric device (Mobil-O-Graph NG, IEM, Stolberg, Germany) for ambulatory BP monitoring with in-built transfer-function like method. Aortic pulse wave velocity (PWV, m/s) and other measures derived from pulse wave analysis such as augmentation index (AIx, %), central SBP (cSBP), central DBP (cDBP) and central pulse pressure (cPP) were computed. Peripheral SBP and DBP, and heart rate (HR) were recorded and pulse pressure (PP) calculated as the difference between SBP and DBP.
Results: After multiple regression analysis adjusting for age, sex, HR and BMI, there was a significant overall effect of IR on measures of large artery stiffness and in central and peripheral BP levels. IR was associated with increased aortic PWV, and with higher central and peripheral SBP and DBP levels. See table.
Hemodynamic variables by tertiles of HOMA index* | ||||
---|---|---|---|---|
Variable | T1 (<0.94) (n=32) | T2 (0.94–1.90) (n=28) | T3 (>1.90) (n=30) | P value |
Peripheral SBP (mmHg) | 111.7 ± 2.0 | 114.3 ± 1.8 | 123.2 ± 2.0 | <0.0001 |
Peripheral DBP (mmHg) | 76.8 ± 1.4 | 79.8 ± 1.3 | 84.7 ± 1.5 | 0.001 |
Peripheral PP (mmHg) | 33.5 ± 1.0 | 35.0 ± 0.9 | 38.4 ± 1.0 | 0.004 |
Central SBP (mmHg) | 103.7 ± 1.7 | 106.7 ± 1.5 | 115.3 ± 1.6 | 0.001 |
Central DBP (mmHg) | 77.8 ± 1.5 | 81.1 ± 1.3 | 86.1 ± 1.5 | 0.001 |
Central PP (mmHg) | 25.5 ± 1.5 | 25.1 ± 1.3 | 29.2 ± 1.0 | 0.071 |
MBP (mmHg) | 92.5 ± 1.5 | 95.7 ± 1.3 | 102.3 ± 1.5 | <0.0001 |
HR (bpm) | 61.3 ± 1.9 | 65.0 ± 1.7 | 66.0 ± 1.9 | 0.212 |
PWV (m/s) | 5.64 ± 0.17 | 5.71 ± 0.10 | 6.34 ± 0.9 | 0.012 |
Augmentation Index (%) | 6.7 ± 3.2 | 6.1 ± 3.8 | 6.9 ± 2.2 | 0.082 |
Values are expressed as means ± SEM
Conclusion: our results indicate that in normotensive, healthy adults, IR may induce significant increases in large artery stiffness (as assessed with aortic PWV) and in central and peripheral BP levels.
Cite this article
TY - JOUR AU - J.E. Ochoa AU - M.M. Correa AU - A.M. Valencia AU - J.G. McEwen AU - J.A. Gallo AU - G. Bilo AU - P. Salvi AU - D. Aristizabal AU - G. Parati PY - 2012 DA - 2012/11/17 TI - P4.16 INSULIN RESISTANCE IS ASSOCIATED WITH INCREASED LARGE ARTERY STIFFNESS IN NORMOTENSIVE HEALTHY ADULTS JO - Artery Research SP - 187 EP - 188 VL - 6 IS - 4 SN - 1876-4401 UR - https://doi.org/10.1016/j.artres.2012.09.164 DO - 10.1016/j.artres.2012.09.164 ID - Ochoa2012 ER -