INSULIN RESISTANCE INPATIENTSWITH CHRONIC HEART FAILURE
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Insulin resistance may be present in patients with heart failure and lias a potential to reduce myocardial as well as skeletal muscle activity. Wehave assessed insulin resistance asmeasured by fasting insulin resistance index (FIR1) in 23 patients with chronic heart failure (CHF) [9 valvular disease. 6 DCM and 8 IHD] and 10 control subjects of similar age and BMI. Fasting glucose, insulin, C-peptidc and lipid profile were estimated. CHF patients had similar mean fasting plasma glucose concentration to control but significantly higher mean plasma insulin (10.57 vs 6.14 mU//L, P < 0.001) and C-peptide (119.4 vs 63.2, P<0.001). Significant insulin resistance.could bedetectedin patients with CHF as assessed by FIRI (P<0.001 vs control), Analysis of variance showed thatFIRI was not related to the etiology' of CHF but to its severity as assessed by NYHA functional classification (P < 0.05). Both EF% and CI were not correlated to FIRI. Our findings showthat patients with CHFare insulin resistant with increased insulin secretion and hyperinsulineinia compared to matched healthy sedentary control group. The degree of insulin resistance was correlatedto severity ofheart failure (NYHA classification) but not to ventricular systolic pump dysfunction or the cause ofCHF. The mechanisms underlying insulin resistance in these cases as well as possible therapeutic implications remain to be further investigated in future studies.