Objectives This study was designed to quantify the prevalence of abnorm al gluc ose tolerance and insulin resistance in patients with idiopathic dilated cardiom yopathy (IDCM). Background Insulin resistance is an independent risk factor for mortality in patients with heart failure(HF) and is a known risk factor for isch emic cardiomyopathy. Though potential physiologic links between insulin resistan ce and HF have been hypothesized, the relationship between insulin resistance an d IDCM remains unclear. Methods A total of 230 consecutive patients from a unive rsity HF clinic were screened for IDCM, the absence of diabetes mellitus, and th e lack of significant co-morbid conditions. Oral glucose tolerance tests were p erformed in the 43 patients with IDCM who met these criteria, and their plasma glucose and insulin responses we re compared with those of 40 healthy volunteers, matched for age, gender, and bo dy mass index. Results Plasma glucose responses were higher during the oral gluc ose tolerance tests in patients with IDCM (p< 0.01), associated with significant ly higher plasma insulin concentrations following the oral glucose challenge(p< 0.01). In addition, abnormalities of glucose tolerance were significantly(p< 0.0 5) more common in patients with IDCM (49%vs. 23%). Conclusions Insulin resista nce and abnormal glucose tolerance are more prevalent in patients with IDCM and represent potentially reversible metabolic derangements in these individuals.
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