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Subclinical impairment of left ventricular function in young obese women: Contributions of polycystic ovary disease and insulin resistance


Kosmala, W and O'Moore-Sullivan, TM and Plaksej, R and Kuliczkowska-Plaksej, J and Przewlocka-Kosmala, M and Marwick, TH, Subclinical impairment of left ventricular function in young obese women: Contributions of polycystic ovary disease and insulin resistance, Journal of Clinical Endocrinology and Metabolism, 93, (10) pp. 3748-3754. ISSN 0021-972X (2008) [Refereed Article]


Copyright Statement

Copyright 2008 by The Endocrine Society

DOI: doi:10.1210/jc.2008-1017


Context: Obesity and insulin resistance (IR) may produce disturbances of left ventricular (LV) function. Obese women with polycystic ovary syndrome (PCO), characterized by hormonal and metabolic abnormalities, are thought to be at particularly increased cardiovascular risk. Objectives: We sought to determine the influence of IR on LV function in obese young women with and without PCO and without other comorbidities. Design: This was a cross-sectional study. Setting: The study was performed at a university hospital. Patients: A total of 150 women aged younger than 40 yr with a body mass index (BMI) of 30 kg/m2 or more was classified into three groups: with both PCO and IR, without PCO and with IR, and without either PCO or IR. Main Outcome Measures: Tissue Doppler-derived myocardial velocities, strain-rate and strain, and metabolic and hormonal measurements were calculated. Results: Subclinical impairment of LV systolic and diastolic function as indicated by lower peak strain (P < 0.001), peak systolic strain rate (P < 0.001), peak early diastolic strain rate (P < 0.001), and peak early diastolic velocity (P < 0.01) was demonstrated in both groups with IR. IR subjects with and without PCO did not differ in any LV function indices. Strain was independently associated with fasting insulin (β = -0.39; P < 0.001), urinary albumin excretion (UAE) (β = -0.36; P < 0.001), and BMI (β = -0.22; P < 0.03), and peak early diastolic strain rate was associated with UAE (β = -0.35; P < 0.001), fasting insulin (β = -0.24; P < 0.02), BMI (β = -0.23; P < 0.02), and SHBG (β = 0.20; P < 0.04). Conclusions: In obese young women, fasting insulin, BMI, SHBG, and UAE are independent correlates of impaired LV performance. The contribution of PCO to LV function abnormalities is linked to IR, but not to other hormonal aberrations associated with this condition.

Item Details

Item Type:Refereed Article
Keywords:Adult; Albuminuria; Androgens; Blood Pressure; Cross-Sectional Studies; Echocardiography, Stress; Exercise Test; Feasibility Studies; Female; Heart Ventricles; Humans; Insulin; Insulin Resistance; Obesity; Polycystic Ovary Syndrome; Sex Hormone-Bindi
Research Division:Biomedical and Clinical Sciences
Research Group:Cardiovascular medicine and haematology
Research Field:Cardiology (incl. cardiovascular diseases)
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Marwick, TH (Professor Tom Marwick)
ID Code:90746
Year Published:2008
Web of Science® Times Cited:34
Deposited By:Menzies Institute for Medical Research
Deposited On:2014-04-23
Last Modified:2015-06-15
Downloads:331 View Download Statistics

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