Cardiac steatosis in diabetes mellitus: a 1H-magnetic resonance spectroscopy study.

Content Provider	Semantic Scholar
Author	McGavock, Jonathan Lingvay, Ildiko Zib, Ivana Tillery, Tommy Salas, Naomi Levine, Benjamin D. Raskin, Philip
Copyright Year	2007
Abstract	BACKGROUND The risk of heart failure in type 2 diabetes mellitus is greater than can be accounted for by hypertension and coronary artery disease. Rodent studies indicate that in obesity and type 2 diabetes mellitus, lipid overstorage in cardiac myocytes produces lipotoxic intermediates that cause apoptosis, which leads to heart failure. In humans with diabetes mellitus, cardiac steatosis previously has been demonstrated in explanted hearts of patients with end-stage nonischemic cardiomyopathy. Whether cardiac steatosis precedes the onset of cardiomyopathy in individuals with impaired glucose tolerance or in patients with type 2 diabetes mellitus is unknown. METHODS AND RESULTS To represent the progressive stages in the natural history of type 2 diabetes mellitus, we stratified 134 individuals (age 45+/-12 years) into 1 of 4 groups: (1) lean normoglycemic (lean), (2) overweight and obese normoglycemic (obese), (3) impaired glucose tolerance, and (4) type 2 diabetes mellitus. Localized (1)H magnetic resonance spectroscopy and cardiac magnetic resonance imaging were used to quantify myocardial triglyceride content and left ventricular function, respectively. Compared with lean subjects, myocardial triglyceride content was 2.3-fold higher in those with impaired glucose tolerance and 2.1-fold higher in those with type 2 diabetes mellitus (P<0.05). Left ventricular ejection fraction was normal and comparable across all groups. CONCLUSIONS In humans, impaired glucose tolerance is accompanied by cardiac steatosis, which precedes the onset of type 2 diabetes mellitus and left ventricular systolic dysfunction. Thus, lipid overstorage in human cardiac myocytes is an early manifestation in the pathogenesis of type 2 diabetes mellitus and is evident in the absence of heart failure.
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Alternate Webpage(s)	http://circ.ahajournals.org/content/circulationaha/116/10/1170.full.pdf?download=true
Alternate Webpage(s)	http://circ.ahajournals.org/content/circulationaha/116/10/1170.full.pdf
PubMed reference number	17698735v1
Volume Number	116
Issue Number	10
Journal	Circulation
Language	English
Access Restriction	Open
Subject Keyword	Apoptosis Arteriopathic disease Artificial cardiac pacemaker Cardiomyopathies Coronary Artery Disease Diabetes Mellitus Diabetes Mellitus, Non-Insulin-Dependent Ejection fraction (procedure) Fatty degeneration Heart Diseases Heart failure Hypertensive disease Impaired glucose tolerance Left Ventricular Function Left ventricular systolic dysfunction Magnetic Resonance Spectroscopy Muscle Cells Myocytes, Cardiac Natural History Obesity Overweight Patients Steatohepatitis Triglycerides Ventricular Dysfunction, Left
Content Type	Text
Resource Type	Article