Insulin Resistance Raises Risk of Heart Failure

Insulin resistance is an independent risk factor for congestive heart failure, this may, in large part, explain the well-known association between obesity and CHF. Dr. Erik Ingelsson, from Uppsala University in Sweden, and colleagues assessed the link between insulin resistance and heart failure by analyzing data from 1187 elderly men who were followed from the early 1990s through 2002. All of the subjects were free from heart failure and vascular disease when the study began.

During a median follow-up period of 8.9 years, 104 developed congestive heart failure, the report indicates.

For a 1-SD increase in the 2-hour glucose value of an oral glucose tolerance test, fasting serum proinsulin level, BMI, and waist circumference, the risk of heart failure increased by 44%, 29%, 35%, and 36%, respectively. Conversely, a 1-SD drop in the clamp glucose disposal rate reduced the risk of heart failure by 34%.

Further analysis showed that the obesity parameters were not significantly predictors of heart failure when the clamp glucose disposal rate was included in the analysis, the authors report.

Insulin resistance appears to be the main link between obesity and heart failure, but further studies are needed to confirm the current results, Dr. Ingelsson’s team concludes.
JAMA 2005;294:334-341.

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