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It has recently been reported that insulin resistance is prevalent in patients with dilated cardiomyopathy (DCM); however, it remains unclear whether insulin resistance is directly induced by DCM or if it is caused by congestive heart failure associated with DCM. We evaluated homeostasis model assessment insulin resistance (HOMA-R) in 14 patients with DCM in comparison with 9 patients with valvular heart diseases (VHD). We also measured the level of serum tumor necrosis factor (TNF)-alpha as a possible causative factor for inducing insulin resistance. Even after the adjustment for age, body mass index, and cardiac function, HOMA-R was significantly higher in patients with DCM than in those with VHD (P = 0.012) (mean +/- SEM: 3.51 +/- 0.59, and 0.80 +/- 0.64, respectively). The serum TNF-alpha level tended to be higher in patients with DCM than in those with VHD; however, the difference was not significant. In conclusion, patients with DCM possess insulin resistance independently of the severity of cardiac dysfunction or serum TNF-alpha, suggesting that insulin resistance in patients with DCM may be closely associated with the pathogenic condition of DCM itself.

Patients With Dilated Cardiomyopathy Possess Insulin Resistance Independently of Cardiac Dysfunction or Serum Tumor Necrosis Factor-.ALPHA.