Results:
There was no significant difference between the patient and control
groups regarding age, gender, height, weight, BMI, and systolic blood
pressure in our study. Although diastolic blood pressure was
significantly lower in the control group, the values were within the
normal reference range (p=0,003). Total cholesterol, LDL, HDL,
Vitamin B12, TSH, and fasting blood glucose levels were similar in the
groups’ blood tests. Fasting insulin levels and HOMA-IR were
significantly higher in the patient group (p
values<0.001). Although significant differences were found in
triglyceride and liver function test levels between the patient and
control groups, the values determined were within the normal reference
range. The demographic characteristics and blood analysis of the patient
and control groups are shown in Table 1.
When the groups’ echocardiographic characteristics were examined, heart
rate and left ventricular ejection fractions were similar (p
values>0,05) . No significant difference was observed in
the patients’ tissue doppler evaluation in terms of E, A waves, lateral
and septal e, a, s waves, IVCT, IVRT, ET, and RVSm (Right ventricular
peak systolic myocardial velocity). E/A and E/e’ ratios, which
are essential parameters for diastolic dysfunction, were significantly
lower in the patient group (respectively, p values are 0.020 and
0.026) , but the deceleration time was similar in both groups. When the
myocardial performance index was evaluated, no significant difference
was observed for the lateral MPI value. At the same time, the septal MPI
value was found to be significantly higher than the control group.
There was no significant difference between the two groups in aortic
systolic and diastolic diameters and carotid artery systolic and
diastolic diameters. In peripheral doppler evaluation with the linear
array transducer, carotid intima-media thicknesses were significantly
higher in the patient group than in the control group (Median
values 0.58 and 0.51, respectively, p=0.001). Brachial flow-mediated
dilatation was lower in the patient group than the control(6.59±0.52, 6.96±0.49, p=0.003). Echocardiographic findings are
shown in Table 2.
Table 3 shows the characteristics of the patient group with and without
insulin resistance and the control group. The relationship of these
differences with insulin resistance and its statistical significance are
summarized in Table 4 and detailed in the discussion section.