Left ventricular hypertrophy and insulin resistance in adults from an urban community in The Gambia: cross-sectional study.

To determine the association between left ventricular hypertrophy and insulin resistance in Gambians.Cross-sectional study.Outpatient clinics of Royal Victoria Teaching Hospital and Medical Research Council Laboratories in Banjul.Three hundred and sixteen consecutive patients were enrolled from outpatient clinics. The data of 275 participants (89 males) were included in the analysis with a mean (± standard deviation) age of 53.7 (±11.9) years.A questionnaire was filled and anthropometric measurements were taken. 2-D guided M-mode echocardiography, standard 12-1ead electrocardiogram, fasting insulin and the oral glucose tolerance test were performed.The Penn formula was used to determine the left ventricular mass index, 125 g/m2 in males and 110 g/m2 in females as the cut-off for left ventricular hypertrophy. Using the fasting insulin and fasting glucose levels, the insulin resistance was estimated by the homeostatic model assessment formula. Logistic regression analysis was used to determine the association between left ventricular hypertrophy and insulin resistance.The mean Penn left ventricular mass index was 119.5 (±54.3) and the prevalence of Penn left ventricular mass index left ventricular hypertrophy was 41%. The mean fasting glucose was 5.6 (±2.5) mmol/l, fasting insulin was 6.39 (±5.49) μU/ml and insulin resistance was 1.58 (±1.45). There was no association between Penn left ventricular mass index left ventricular hypertrophy and log of insulin resistance in univariate (OR = 0.98, 95% CI = 0.80-1.19, p = 0.819) and multivariate logistic regression (OR = 0.93, 95% CI = 0.76-1.15, p = 0.516) analysis.No association was found in this study between left ventricular hypertrophy and insulin resistance in Gambians and this does not support the suggestion that insulin is an independent determinant of left ventricular hypertrophy in hypertensives

The clinical characteristics of participants by sex.

<p>t  =  Two sample t test with equal variance.</p><p>P  =  Statistical significance of difference.</p><p>n  =  Number.</p><p>SD  =  Standard deviation.</p><p>BMI  =  Body Mass Index BMI ≥ 30 (kg/m²)  =  General obesity.</p><p>WHR  =  Waist hip ratio  =  Central obesity.</p><p>SBP  =  Systolic Blood Pressure.</p><p>DBP  =  Diastolic Blood Pressure.</p

Left ventricular hypertrophy among chronic kidney disease patients in Ghana

Introduction: The presence of left ventricular hypertrophy (LVH) in patients with Chronic Kidney Disease (CKD) is associated with worsening cardiovascular outcomes. There is a dearth of data on LVH in Ghanaian CKD patients. Methods: This was a cross sectional study carried out at the Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana. A questionnaire was used to obtain information on clinical features of CKD. The MDRD-4 equation was used to calculate eGFR. Information on the prevalence and factors associated with electrocardiographic left ventricular hypertrophy were obtained during the initial assessment. Results: About 64.5% of the 203 participants were male and the mean age was 43.9 ± 17.8 years. Most subjects (79.8%) had stage 5 disease. The mean systolic and diastolic blood pressures were 167.86 ± 39.87 and 101.8 ± 24.4 respectively. Approximately 43% of respondents had LVH. eGFR correlated negatively with LVH. High systolic pressure (OR 4.9, CI 2.4 – 10.4; p &lt; 0.05), high diastolic pressure (OR 8.1, CI 4.0 – 16.1; p &lt; 0.05) increased pulse pressure (OR 3.4 CI 2.6-9.3, p &lt; 0.05), increased body mass index (OR 3.6 CI 1.7-11.2, p &lt; 0.001) as well as male gender (OR 4.7, 95% CI 2.4 – 9.1; p &lt;0.05) were associated with the presence of LVH.Conclusion: LVH is common in our cohort. High pulse pressure, high DBP, increased BMI and male gender are significant associated factors. Adequate treatment of high blood pressure as well as early detection of LVH and interventions aimed at prevention and/or regression of LVH are to be encouraged

Univariate analysis of variables with PVLMILVH as the outcome variable.

<p>P  =  Statistical test of significance of association.</p><p>CI  =  Confidence Interval.</p><p>OR  =  Odds Ratio.</p><p>BMI  =  Body Mass Index BMI≥30 (kg/m²)  =  General obesity.</p><p>WHR  =  Waist hip ratio  =  Central obesity.</p><p>SBP  =  Systolic Blood Pressure.</p><p>DBP  =  Diastolic Blood Pressure.</p><p>HIGH WHR  =  WHR>0.9 for males and >0.8 for females.</p

The biochemical characteristics of participants by sex.

<p>t  =  Two sample t test with equal variance.</p><p>P  =  statistical significance of difference.</p><p>n  =  Number.</p><p>SD  =  Standard deviation.</p

Univariate analysis of variables with log of Insulin Resistance as the outcome variable.

<p>P  =  Statistical test of significance of association.</p><p>CI  =  Confidence Interval.</p><p>R  =  Regression Coefficient.</p><p>BMI  =  Body Mass Index BMI≥30 (kg/m²)  =  General obesity.</p><p>WHR  =  Waist hip ratio  =  Central obesity.</p><p>SBP  =  Systolic Blood Pressure.</p><p>DBP  =  Diastolic Blood Pressure.</p><p>HIGH WHR  =  WHR>0.9 for males and >0.8 for females.</p

Multivariate analysis of variables with PVLMILVH as the outcome variable and log of Insulin Resistance as the explanatory variable.

<p>P  =  Statistical test of significance of association.</p><p>CI  =  Confidence Interval.</p><p>R  =  Regression Coefficient.</p><p>BMI  =  Body Mass Index BMI≥30 (kg/m²)  =  General obesity.</p><p>WHR  =  Waist hip ratio  =  Central obesity.</p><p>HIGH WHR  =  WHR>0.9 for males and >0.8 for females.</p

The echocardiographic characteristics of participants by sex.

<p>t  =  Two sample t test with equal variance.</p><p>χ ²  =  Pearson chi squared test.</p><p>P  =  statistical significance of difference.</p><p>n  =  Number.</p><p>SD  =  Standard deviation.</p><p>* Number.</p