Potentiation of abnormalities in myocardial metabolism with the development of diabetes in women with obesity and insulin resistance
Journal of Nuclear Cardiology, 04/27/2011McGill JB et al.
In women, the presence of obese (OB) and diabetes mellitus (DM) compared with OB alone is associated with a greater reliance on myocardial fatty acid (FA) metabolism at the expense of glucose metabolism. These perturbations in myocardial metabolism are not associated in a decline left ventricular efficiency or function suggesting that the metabolic perturbations may precede an eventual decline left ventricular function as is seen in animal models of DM.
Women who were lean volunteers (NV) (N = 14; age 35 ± 17 years, body mass index 23 ± 1 kg/m2), OB (N = 28;31 ± 6 years, BMI 39 ± 7 kg/m2), and DM (n = 22; 54 ± 11 years, BMI 38 ± 5 kg/m2) were studied
Cardiac positron emission tomography was performed for the determination of myocardial blood flow, oxygen consumption, FA and glucose metabolism
Cardiac work was measured by echocardiography and efficiency by the ratio of work to myocardial oxygen consumption
Fractional glucose uptake was comparable between NV and OB but lower in DM (P < .05 versus NV)
Myocardial FA utilization and oxidation were both higher in DM compared with NV and OB (P < .0001)
Myocardial FA utilization and oxidation had positive correlations with HOMA (R = 0.35, P = .005 and R = 0.40, P = .001, respectively) whereas fractional glucose uptake exhibited an inverse correlation (R = -.31, P = .01)
Cardiac work and efficiency were similar among the three groups
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