PMID- 19047320
OWN - NLM
STAT- MEDLINE
DCOM- 20090508
LR  - 20221109
IS  - 1399-3003 (Electronic)
IS  - 0903-1936 (Print)
IS  - 0903-1936 (Linking)
VI  - 33
IP  - 2
DP  - 2009 Feb
TI  - Insulin resistance in pulmonary arterial hypertension.
PG  - 318-24
LID - 10.1183/09031936.00000508 [doi]
AB  - Although obesity, dyslipidemia and insulin resistance (IR) are well known risk 
      factors for systemic cardiovascular disease, their impact on pulmonary arterial 
      hypertension (PAH) is unknown. The present authors' previous studies indicate 
      that IR may be a risk factor for PAH. The current study has investigated the 
      prevalence of IR in PAH and explored its relationship with disease severity. 
      Clinical data and fasting blood samples were evaluated in 81 nondiabetic PAH 
      females. In total, 967 National Health and Nutrition Examination Surveys (NHANES) 
      females served as controls. The fasting triglyceride to high-density lipoprotein 
      cholesterol ratio was used as a surrogate of insulin sensitivity. While body mass 
      index was similar in NHANES versus PAH females (28.6 versus 28.7 kg.m(-2)), PAH 
      females were more likely to have IR (45.7 versus 21.5%) and less likely to be 
      insulin sensitive (IS; 43.2 versus 57.8%). PAH females mostly (82.7%) had New 
      York Heart Association (NYHA) class II and III symptoms. Aetiology, NYHA class, 
      6-min walk-distance and haemodynamics did not differ between IR and IS PAH 
      groups. However, the presence of IR and a higher NYHA class was associated with 
      poorer 6-months event-free survival (58 versus 79%). Insulin resistance appears 
      to be more common in pulmonary arterial hypertension females than in the general 
      population, and may be a novel risk factor or disease modifier that might impact 
      on survival.
FAU - Zamanian, R T
AU  - Zamanian RT
AD  - Division of Pulmonary and Critical Care Medicine, 300 Pasteur Dr., Room H3147, 
      Stanford, CA 94305, USA. zamanian@stanford.edu
FAU - Hansmann, G
AU  - Hansmann G
FAU - Snook, S
AU  - Snook S
FAU - Lilienfeld, D
AU  - Lilienfeld D
FAU - Rappaport, K M
AU  - Rappaport KM
FAU - Reaven, G M
AU  - Reaven GM
FAU - Rabinovitch, M
AU  - Rabinovitch M
FAU - Doyle, R L
AU  - Doyle RL
LA  - eng
GR  - R01 HL074186/HL/NHLBI NIH HHS/United States
GR  - R01 HL074186-01A1/HL/NHLBI NIH HHS/United States
GR  - R01 HL087118/HL/NHLBI NIH HHS/United States
GR  - 1-R01-HL074186-01/HL/NHLBI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20081201
PL  - England
TA  - Eur Respir J
JT  - The European respiratory journal
JID - 8803460
RN  - 0 (Triglycerides)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Case-Control Studies
MH  - Disease-Free Survival
MH  - Female
MH  - Hemodynamics
MH  - Humans
MH  - Hypertension, Pulmonary/metabolism/*pathology
MH  - *Insulin Resistance
MH  - Middle Aged
MH  - Pulmonary Artery/*pathology
MH  - Risk Factors
MH  - Time Factors
MH  - Treatment Outcome
MH  - Triglycerides/metabolism
PMC - PMC2785883
MID - NIHMS99141
EDAT- 2008/12/03 09:00
MHDA- 2009/05/09 09:00
PMCR- 2010/02/01
CRDT- 2008/12/03 09:00
PHST- 2008/12/03 09:00 [pubmed]
PHST- 2009/05/09 09:00 [medline]
PHST- 2008/12/03 09:00 [entrez]
PHST- 2010/02/01 00:00 [pmc-release]
AID - 09031936.00000508 [pii]
AID - 10.1183/09031936.00000508 [doi]
PST - ppublish
SO  - Eur Respir J. 2009 Feb;33(2):318-24. doi: 10.1183/09031936.00000508. Epub 2008 
      Dec 1.