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The Role of Insulin Resistance to Subclinical Left Ventricle Systolic Dysfunction in Metabolic Syndrome

Author : A. Gayatri, R Sukmawan, A Santoso
Upload Date : 19-04-2018

Background. Subclinical myocardial dysfunction is a dangerous consequence of the metabolic syndrome, which is assumingly caused by insulin resistance. The disorder is an early pathological condition, which poses a risk of heart failure in the future. Through Two Dimensional-Speckle Tracking Echocardiography (2D-STE) with the Global Longitudinal Strain (GLS) parameters that have high sensitivity and specificity, these myocardial dysfunctions can be detected earlier.

Methods. A cross-sectional study, using 483 secondary data from employees of the National Heart Center of Harapan Kita. 119 subjects were included in the inclusion and exclusion criteria, which were performed using 2D-STE with GLS parameter. The subjects were divided into two groups of non-insulin resistance and insulin resistance based on the value of Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) with a cut-off value of 2.0.

Result. There were significant differences in GLS values between the insulin resistance group and non-insulin resistance [mean -18.3 (SD 3.05) vs -19.7 (2.2)%; CI of 95% -2.39 - (- 0.37)], P = 0.008). Insulin resistance has the greatest risk followed by triglyceride levels (adjusted OR of 2.8, P = 0.009 and OR of 2.4, P = 0.03) respectively to subclinical left ventricular systolic dysfunction in the metabolic syndrome.

Conclusion. Insulin resistance showed a lower left ventricle systolic function (as expressed by GLS score) significantly than the non-insulin resistance in the metabolic syndrome. Insulin resistance and triglycerides is an independent marker of subclinical left ventricular systolic dysfunction among other components of the metabolic syndrome.

KEYWORDS : insulin resistance, HOMA-IR, subclinical left ventricle systolic dysfunction, GLS, metabolic syndrome, triglycerides

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