Left ventricular hypertrophy and body mass index in patients with diabetes mellitus type 2 and hypertension
Annotatsiya
Our aim was to examine the association between body mass index (BMI) and left ventricular hypertrophy (LVH) in patients with diabetes mellitus (DM) type 2 and hypertension. There were observed 40 patients with DM type 2 and hypertension (mean age was 52,2 ± 2,16 year) by echocardiography. The traces were read according to the Penn convention and the left ventricular internal diameter (LVID), interventricular septum thickness (IVST) and posterior wall thickness (PWT) were measured at the end of the diastole. Left ventricular mass (LVM) was calculated according to the Devereux formula: LVM (g) = 1.04*[(IVSTd + PWTd +LVIDd )3 – (LVIDd)3] –13.6. LVM index (LVMI) was obtained by dividing the LVM by body surface area. LVH was defined as LVMI >134 g/m2 for men and >110 g/m2 for women. Relative wall thickness (RWT) was calculated by the formula 100*(IVST+PWT)/LVID. Concentric hypertrophy was estimated when RWT was above 45% and eccentric hypertrophy was estimated when RWT was below 45%. All patients were divided for 3 groups dependence on BMI. The first group (n=12) consisted of patients with BMI 18.5-24.9 kg/ m2, the second one (n=13) consisted of patients with BMI 25-29.9 kg/ m2, and the third one (n=15) consisted of patients with BMI >30 kg/ m2. It was found the positive association between BMI and BP, as patients with obesity have had greater level SBP 163.5 ± 2.5 mm.Hg and DBP 99.1 ± 1.4 mm.Hg in comparison with those with preobesity (SBP 157.8 ± 1.95 mm.Hg and DBP 94.2 ± 1.3 mm.Hg, p<0.01) and with normal weight (SBP 152.5 ± 1.73 mm.Hg and DBP 90.0 ± 2.3 mm.Hg, p<0.001). Moreover, it was estimated the dependence of LVH on BMI, as LVM was significantly higher in obese patients than in those with normal weight (334.13 ± 19.91g vs 273.82 ± 18.86g, p<0.01). LVMI also was significantly greater in obese patients in comparison with those with normal weight (159.32 ± 1.47g/ m2 vs 129.43 ± 9.65 g/ m2, p<0.05). The evaluation of the values RWT has shown that concentric hypertrophy was characteristic for patients with preobesity and obesity (RWT 46.99 ± 2.5% and 50.37 ± 1.9%), but patients with normal weight have had eccentric hypertrophy (RWT 44.0 ± 3.7%). This study demonstrates that obesity is strong risk factor for development of LVH and concentric remodeling in patients DM type 2 and hypertension.