Obesidade abdominal, resistência à insulina e hipertensão: Impacto sobre a massa e a função do ventrículo esquerdo em mulheres

Abstract

Objective: To evaluate the relationship between central obesity, hyperinsulinemia and arterial hypertension with left ventricular mass and geometry in women. Methods: This study included 70 women (35-68 years), divided into four groups according to the presence of central obesity and hypertension. Visceral fat area was determined. Blood glucose and plasma insulin were determined before and two hours after an oral 75g glucose load, and the patients were submitted to cardilogical evaluation. Results: Compared to NT-OB, HT-OB presented higher levels of plasma insulin at 2h-OGTT (127.5 ± 73.0 vs 86.8 ± 42.7 μU/ml; p=0.05) and reduced E wave/A wave ratio (E/A) (0.8 ± 0.1 vs 1.2 ± 0.3; p < 0.05). Compared to NT-NO, HT-NO showed higher insulin levels before glucose load (7.46 ± 3.1 vs 4.32 ± 2.1 μU/ml; p < 0.05), higher HOMAr (1.59 ± 0.72 vs 0.93 ± 0.48 mmol.mU/l2; p=0.006), higher leptin level (19.1 ± 9.6 vs 7.4 ± 3.5 ng/ml; p=0.028), greater VF area (84.40 ± 55.7 vs 37.50 ± 23.0 cm2; p=0.036), increased IVSTd (9.6 ± 1.2 vs 8.2 ± 1.7 mm; p <0.05) and (LVM/height) (95.8 ± 22.3 vs 78.4 ± 15.5 g/m; p < 0.05). Multiple linear regression analysis showed age, BMI and fasting glucose as determinants on LVM/height (R2 = 0.59; p < 0.05). Conclusion: Our results indicate an association among hypertension, central obesity and left ventricular hypertrophy through increases in sympathetic activity and insulin resistance.