Relationship of blood pressure and left ventricular mass to serum insulin levels in newly diagnosed non-insulin-dependent (type 2) diabetic patients and in non-diabetic subjects

Abstract

The relationship of blood pressure to fasting and postglucose serum insulin and lipid levels was examined in 133 (70 men, 63 women) newly diagnosed, non-insulin-dependent diabetic patients and 144 (62 men, 82 women) non-diabetic control subjects. In addition, the frequency of left ventricular hypertrophy by ECG criteria and left ventricular mass determined by M-mode echocardiography in diabetic patients were compared to that in non-diabetic subjects. Fasting serum insulin showed a significant correlation with systolic and diastolic blood pressure levels in male non-diabetic subjects, but not in male and female diabetic or in female non-diabetic subjects. Postglucose serum insulin levels showed no significant correlations with systolic or diastolic blood pressure levels in men, but in female diabetic and non-diabetic subjects significant correlations were found in particular with systolic blood pressure level. The correlations between serum insulin and blood pressure levels could not be accounted for by obesity. In male and female diabetic subjects serum triglycerides correlated positively with systolic and diastolic blood pressure levels even after adjustment for obesity. No significant difference was found in the prevalence of left ventricular hypertrophy based on ECG criteria between diabetic and non-diabetic subjects, but female diabetic subjects showed in echocardiography an increased left ventricular mass related to body surface area compared to their non-diabetic counterparts. Elevated systolic blood pressure and high postglucose serum insulin levels showed an independent, significant association with left ventricular mass in female diabetic subjects.