Insulin Resistance, Arterial Stiffness And Circulating Atrial Natriuretic Peptide Levels In Young Ghanaian Adults

Abstract

Insulin resistance is an independent predictor of a wide range of major illnesses, including stroke, type 2 diabetes, cardiovascular diseases (CVDs), hypertension and cancer. Insulin resistance commonly coexist with obesity and arterial stiffness resulting in hypertension and CVDs. Obese people with insulin resistance have lower plasma levels of natriuretic peptides such as atrial- and brain- natriuretic peptides (ANP and BNP), and these play an important role in the development of arterial stiffness and essential hypertension. Biomarkers such as plasma ANP levels and arterial stiffness measurements are improved tools that can help to identify individuals who are at high-risk of developing CVDs and for management. This study investigated the burden of insulin resistance, arterial stiffness and plasma levels of atrial natriuretic peptide, which are known markers and indicators of cardiovascular diseases (CVDs). This study was conducted in Accra, Ghana, a questionnaire was administered to assess information on the lifestyle of the participants and anthropometric indices such as body fat, weight, height, waist and hip circumferences were also measured. Tensionmed Arteriograph was used to measure blood pressure and aortic stiffness (pulse wave velocity). Fasting venous blood samples were obtained from each participant for fasting blood glucose, plasma lipids were measured, insulin and ANP levels were also determined by Sandwich ELISA. BMI, WHR, IR were determined and statistical analyses were done using SPSS to test for associations and significant differences. A total of 300 young adults within the age range of 20-30 years were studied, 36.1% males and 63.9% females. The mean age for the study participants was 23.9yrs, significant differences were observed in the mean weights (75.84 vs 72.66, p = 0.0103), Hips circumference (121.93 vs 105.31, p < 0.0001) and BMI (26.95 vs 25.65, p = 0.0054) comparing the females to the males. The overall prevalence of obesity and overweight among the study participants were 20.61% and 48.48% respectively and these were significantly higher among the females as compared to the males (26.07 vs 10.92% and 48.82% vs 47.90%, p = 0.0003). The overall mean PWV, IR and ANP among the study participants were 7.22 ± 2.29, 0.92 ± 0.20 and 4.94 ± 1.88 respectively, however there was no significant difference in the mean PWV and IR with regards to gender (p > 0.05), however there were significant associations of PWV with WHR and BMI. Deductions from this study suggest that the prevalence of obesity and overweight were high among the young adults, therefore lifestyle modifications such as improved diets and increased physical activity are highly recommended for young adults in order for IR and arterial stiffness prevention.