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Insulin resistance in idiopathic dilated cardiomyopathy: a possible etiologic link

Ronald M Witteles1, W H Wilson Tang, Aamer H Jamali

  • 1Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, California 94305-5406, USA.

Journal of the American College of Cardiology
|July 6, 2004
PubMed

Insights

Patients with idiopathic dilated cardiomyopathy (IDCM) show higher rates of abnormal glucose tolerance and insulin resistance. These metabolic issues may be reversible, offering potential treatment avenues for IDCM patients.

Area of Science:

  • Cardiology
  • Endocrinology
  • Metabolic Syndrome

Background:

  • Insulin resistance is a known risk factor for mortality in heart failure (HF) and ischemic cardiomyopathy.
  • The specific relationship between insulin resistance and idiopathic dilated cardiomyopathy (IDCM) is not well-defined.
  • Understanding metabolic derangements in IDCM is crucial for patient outcomes.

Purpose of the Study:

  • To quantify the prevalence of abnormal glucose tolerance.
  • To determine the incidence of insulin resistance in patients diagnosed with IDCM.
  • To investigate the link between metabolic abnormalities and IDCM.

Main Methods:

  • Screened 230 patients from a university HF clinic for IDCM, excluding diabetes and major comorbidities.
  • Conducted oral glucose tolerance tests on 43 eligible IDCM patients.
  • Compared glucose and insulin responses in IDCM patients against 40 healthy, matched volunteers.

Main Results:

  • IDCM patients exhibited significantly higher plasma glucose responses post-glucose challenge (p < 0.01).
  • Elevated plasma insulin concentrations were observed in IDCM patients following oral glucose intake (p < 0.01).
  • Abnormal glucose tolerance was significantly more common in IDCM patients (49%) compared to controls (23%, p < 0.05).

Conclusions:

  • Insulin resistance and abnormal glucose tolerance are highly prevalent in individuals with IDCM.
  • These metabolic derangements in IDCM may be potentially reversible.
  • Identifying and addressing these metabolic factors could improve management strategies for IDCM.
Abstract

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