Association of fasting blood sugar level, insulin level, and obesity with left ventricular mass in healthy children and adolescents: The Bogalusa Heart Study

Background Insulin resistance, often associated with obesity, is hypothesized to be involved in the pathogenesis of essential hypertension and may relate to increased left ventricular mass (LVM). Methods We examined correlations between echocardiographic LVM and fasting blood glucose and insulin levels in a cross-section of 216 black and white healthy children and young adults aged 13 to 27 years in Bogalusa, Louisiana. Anthropometric measurements and blood pressure readings were also obtained. Results Positive bivariate correlation was found between fasting blood glucose level and LVM corrected for growth (LVMC) (LVMC = LVM/Height2.7) with all race/sex groups combined (r = 0.17, P ≤ .03). Multivariate analyses in a model including race, sex, age, and measures of body size showed no significant correlations between fasting blood glucose level, insulin level, and LVMC. However, when patients were ranked in terciles by fasting insulin level and within each tercile by subscapular skinfold thickness or weight tercile, increasing LVMC with increasing insulin level was found in the highest subscapular skinfold thickness and weight terciles. The largest difference was between high and low insulin groups (P ≤ .03). When grouped by systolic blood pressure tercile, there was no difference in LVMC with increasing fasting insulin tercile. We concluded that in heavier individuals, increased insulin levels may be a risk factor for the accumulation of increased LVMC independent of any relation among insulin, obesity, and blood pressure. (Am Heart J 1999;138:122-7.)