Context: Obesity and insulin resistance (IR) may produce disturbances of left ventricular (LV) function. Obese women with polycystic ovary syndrome (PCO), characterized by hormonal and metabolic abnormalities, are thought to be at particularly increased cardiovascular risk.

Objectives: We sought to determine the influence of IR on LV function in obese young women with and without PCO and without other comorbities.

Design: Prospective, cross-sectional study.

Setting: University hospital.

Patients: 150 women aged <40 years with body mass index (BMI)30kg/m² classified into 3 groups: with PCO and IR and 2 groups without PCO: one with and the other without IR.

Main outcome measures: Tissue Doppler-derived myocardial velocities, strain-rate and strain, metabolic and hormonal measurements.

Results: Subclinical impairment of LV systolic and diastolic function as indicated by lower peak strain (p<0.001), peak systolic strain rate (SRs) (p<0.001), peak early diastolic strain rate (SRe) (p<0.001), and peak early diastolic velocity (p<0.01) were demonstrated in both groups with IR. IR subjects with and without PCO did not differ in any LV function indices. Strain was independently associated with fasting insulin (=-0.39,p<0.001), urinary albumin excretion (UAE) (=-0.36,p<0.001), and BMI (=-0.22,p<0.03), and SRe was associated with UAE (=-0.35,p<0.001), fasting insulin (=-0.24,p<0.02), BMI (=-0.23,p<0.02), and sex hormone-binding globulin (SHBG) (=0.20,p<0.04).

Conclusions: In obese young women, fasting insulin, BMI, SHBG and UAE are independent correlates of impaired LV performance. The contribution of PCO to LV function abnormalities is linked to IR, but not to other hormonal aberrations associated with this condition.