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.