Left Ventricular Hypertrophy and Insulin Resistance in Adults from an Urban Community in the Gambia: Cross-Sectional Study

Objective: To determine the association between left ventricular hypertrophy and insulin resistance in Gambians. Design: Cross-sectional study. Setting: Outpatient clinics of Royal Victoria Teaching Hospital and Medical Research Council Laboratories in Banjul. Participants: 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. Interventions: 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. Main Outcome Measures: The Penn formula was used to determine the left ventricular mass index, 125 g/m(2) 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. Results: 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) mu U/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. Conclusion: 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.