Glucose effectiveness is strongly related to left ventricular mass in subjects with stage I hypertension or high-normal blood pressure

Background: Evidence suggests that "glucose effectiveness," (SG) or the effect of glucose per se to enhance net glucose disposal, may be at least as important as the insulin sensitivity index (SI) in the assessment of glucose tolerance. Our objective was to study the relationship of SG and SI parameters to left ventricular mass in a group of untreated, nondiabetic, and nonobese subjects recently diagnosed with stage I or high-normal blood pressure (BP). Methods: In this sample of subjects, among whom the expected prevalence of insulin resistance is low, we assessed SG and SI parameters using the intravenous glucose tolerance test and minimal model analysis. We also measured left ventricular mass (LVM) index and diastolic function by echocardiography. Results: We observed a strong relationship between SG and LVM index (r = -0.61, P < .0001). Patients with left ventricular hypertrophy (LVH) had lower SG than those without LVH (0.1114+/-0.04 v 0.2088+/-0.08 X 10(-1) min(-1), P < .001). In contrast, patients below the lowest quartile of the SG parameter distribution had higher LVM index (126.4+/-23.1 v 94.8+/-22.3 g/rn(2), p<.001) and also had higher prevalence of LVH than the other patients (P < .0001). The SI related only to diastolic dysfunction, suggesting that SG may be an earlier marker of LVH than SI in hypertension. Conclusion: In this sample of nonobese and glucose-tolerant subjects with an early stage of hypertension, SG but not SI was related to LVM. (C) 2004 American Journal of Hypertension, Ltd.