Cardiac Insulin Resistance in Subjects With Metabolic Syndrome Traits and Early Subclinical Atherosclerosis.

IF 14.8 1区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes Care Pub Date : 2023-11-01 DOI:10.2337/dc23-0871

Ana Devesa, Valentin Fuster, Ravi Vazirani, Inés García-Lunar, Belén Oliva, Samuel España, Andrea Moreno-Arciniegas, Javier Sanz, Cristina Perez-Herreras, Héctor Bueno, Enrique Lara-Pezzi, Ana García-Alvarez, Vicente Martínez de Vega, Leticia Fernández-Friera, Maria G Trivieri, Antonio Fernández-Ortiz, Xavier Rossello, Javier Sanchez-Gonzalez, Borja Ibanez

{"title":"Cardiac Insulin Resistance in Subjects With Metabolic Syndrome Traits and Early Subclinical Atherosclerosis.","authors":"Ana Devesa, Valentin Fuster, Ravi Vazirani, Inés García-Lunar, Belén Oliva, Samuel España, Andrea Moreno-Arciniegas, Javier Sanz, Cristina Perez-Herreras, Héctor Bueno, Enrique Lara-Pezzi, Ana García-Alvarez, Vicente Martínez de Vega, Leticia Fernández-Friera, Maria G Trivieri, Antonio Fernández-Ortiz, Xavier Rossello, Javier Sanchez-Gonzalez, Borja Ibanez","doi":"10.2337/dc23-0871","DOIUrl":null,"url":null,"abstract":"Objective: Experimental evidence suggests that metabolic syndrome (MetS) is associated with changes in cardiac metabolism. Whether this association occurs in humans is unknown.Research design and methods: 821 asymptomatic individuals from the Progression of Early Subclinical Atherosclerosis (PESA) study (50.6 [46.9-53.6] years, 83.7% male) underwent two whole-body 18F-fluorodeoxyglucose positron emission tomography-magnetic resonance (18F-FDG PET-MR) 4.8 ± 0.6 years apart. Presence of myocardial 18F-FDG uptake was evaluated qualitatively and quantitatively. No myocardial uptake was grade 0, while positive uptake was classified in grades 1-3 according to target-to-background ratio tertiles.Results: One hundred fifty-six participants (19.0%) showed no myocardial 18F-FDG uptake, and this was significantly associated with higher prevalence of MetS (29.0% vs. 13.9%, P < 0.001), hypertension (29.0% vs. 18.0%, P = 0.002), and diabetes (11.0% vs. 3.2%, P < 0.001), and with higher insulin resistance index (HOMA-IR, 1.64% vs. 1.23%, P < 0.001). Absence of myocardial uptake was associated with higher prevalence of early atherosclerosis (i.e., arterial 18F-FDG uptake, P = 0.004). On follow-up, the associations between myocardial 18F-FDG uptake and risk factors were replicated, and MetS was more frequent in the group without myocardial uptake. The increase in HOMA-IR was associated with a progressive decrease in myocardial uptake (P < 0.001). In 82% of subjects, the categorization according to presence/absence of myocardial 18F-FDG uptake did not change between baseline and follow-up. MetS regression on follow-up was associated with a significant (P < 0.001) increase in myocardial uptake.Conclusions: Apparently healthy individuals without cardiac 18F-FDG uptake have higher HOMA-IR and higher prevalence of MetS traits, cardiovascular risk factors, and early atherosclerosis. An improvement in cardiometabolic profile is associated with the recovery of myocardial 18F-FDG uptake at follow-up.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":null,"pages":null},"PeriodicalIF":14.8000,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10632182/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Diabetes Care","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2337/dc23-0871","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}

引用次数: 0

Abstract

Objective: Experimental evidence suggests that metabolic syndrome (MetS) is associated with changes in cardiac metabolism. Whether this association occurs in humans is unknown.

Research design and methods: 821 asymptomatic individuals from the Progression of Early Subclinical Atherosclerosis (PESA) study (50.6 [46.9-53.6] years, 83.7% male) underwent two whole-body 18F-fluorodeoxyglucose positron emission tomography-magnetic resonance (18F-FDG PET-MR) 4.8 ± 0.6 years apart. Presence of myocardial 18F-FDG uptake was evaluated qualitatively and quantitatively. No myocardial uptake was grade 0, while positive uptake was classified in grades 1-3 according to target-to-background ratio tertiles.

Results: One hundred fifty-six participants (19.0%) showed no myocardial 18F-FDG uptake, and this was significantly associated with higher prevalence of MetS (29.0% vs. 13.9%, P < 0.001), hypertension (29.0% vs. 18.0%, P = 0.002), and diabetes (11.0% vs. 3.2%, P < 0.001), and with higher insulin resistance index (HOMA-IR, 1.64% vs. 1.23%, P < 0.001). Absence of myocardial uptake was associated with higher prevalence of early atherosclerosis (i.e., arterial 18F-FDG uptake, P = 0.004). On follow-up, the associations between myocardial 18F-FDG uptake and risk factors were replicated, and MetS was more frequent in the group without myocardial uptake. The increase in HOMA-IR was associated with a progressive decrease in myocardial uptake (P < 0.001). In 82% of subjects, the categorization according to presence/absence of myocardial 18F-FDG uptake did not change between baseline and follow-up. MetS regression on follow-up was associated with a significant (P < 0.001) increase in myocardial uptake.

Conclusions: Apparently healthy individuals without cardiac 18F-FDG uptake have higher HOMA-IR and higher prevalence of MetS traits, cardiovascular risk factors, and early atherosclerosis. An improvement in cardiometabolic profile is associated with the recovery of myocardial 18F-FDG uptake at follow-up.

查看原文本刊更多论文

代谢综合征和早期亚临床动脉粥样硬化患者的心脏胰岛素抵抗。

目的：实验证据表明代谢综合征（MetS）与心脏代谢变化有关。这种关联是否发生在人类身上尚不清楚。研究设计和方法：来自早期亚临床动脉粥样硬化进展（PESA）研究的821名无症状个体（50.6[46.9-53.6]岁，83.7%男性）接受了两次全身18F-氟脱氧葡萄糖正电子发射断层扫描磁共振（18F-FDG PET-MR），时间间隔4.8±0.6年。对心肌18F-FDG摄取的存在进行定性和定量评估。无心肌摄取为0级，而阳性摄取根据目标与背景比率三分位数分为1-3级。结果：156名参与者（19.0%）没有心肌18F-FDG摄取，这与代谢综合征（29.0%对13.9%，P<0.001）、高血压（29.0%对18.0%，P=0.002）和糖尿病（11.0%对3.2%，P<0.001，胰岛素抵抗指数较高（HOMA-IR，1.64%对1.23%，P<0.001）。心肌摄取不足与早期动脉粥样硬化的患病率较高相关（即动脉18F-FDG摄取，P=0.004）。在随访中，心肌18F-FDG摄取与危险因素之间的关联被复制，并且在没有心肌摄取的组中MetS更常见。HOMA-IR的增加与心肌摄取的逐渐减少有关（P<0.001）。在82%的受试者中，根据心肌18F-FDG摄取的存在/不存在进行的分类在基线和随访之间没有变化。随访中的MetS回归与心肌摄取的显著增加有关（P＜0.001）。结论：没有心脏18F-FDG摄取的健康个体具有较高的HOMA-IR和较高的MetS特征、心血管危险因素和早期动脉粥样硬化的患病率。心脏代谢状况的改善与随访时心肌18F-FDG摄取的恢复有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Diabetes Care 医学-内分泌学与代谢

CiteScore

27.80

自引率

4.90%

发文量

449

审稿时长

1 months

期刊介绍： The journal's overarching mission can be captured by the simple word "Care," reflecting its commitment to enhancing patient well-being. Diabetes Care aims to support better patient care by addressing the comprehensive needs of healthcare professionals dedicated to managing diabetes. Diabetes Care serves as a valuable resource for healthcare practitioners, aiming to advance knowledge, foster research, and improve diabetes management. The journal publishes original research across various categories, including Clinical Care, Education, Nutrition, Psychosocial Research, Epidemiology, Health Services Research, Emerging Treatments and Technologies, Pathophysiology, Complications, and Cardiovascular and Metabolic Risk. Additionally, Diabetes Care features ADA statements, consensus reports, review articles, letters to the editor, and health/medical news, appealing to a diverse audience of physicians, researchers, psychologists, educators, and other healthcare professionals.