Kim Gyuri, Jo Kwanhyeong, Kim Kwang Joon, Lee Yong-ho, Han Eugene, Yoon Hye-jin, Wang Hye Jin, Kang Eun Seok, Yun Mijin
Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, 50-1, Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
Graduate School, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea.
Cardiovasc Diabetol. 2015 Nov 4;14:148. doi: 10.1186/s12933-015-0310-4.
The heart requires constant sources of energy mostly from free fatty acids (FFA) and glucose. The alteration in myocardial substrate metabolism occurs in the heart of diabetic patients, but its specific association with other metabolic variables remains unclear. We aimed to evaluate glucose uptake in hearts of subjects with normal glucose tolerance (NGT), prediabetes, and type 2 diabetes mellitus (T2DM) using [(18)F]-fluorodeoxyglucose-positron emission tomography ((18)FDG-PET) in association with visceral and subcutaneous adiposity, and metabolic laboratory parameters.
A total of 346 individuals (NGT, n = 76; prediabetes, n = 208; T2DM, n = 62) in a health promotion center of a tertiary hospital were enrolled. The fasting myocardial glucose uptake, and visceral and subcutaneous fat areas were evaluated using (18)FDG-PET and abdominal computed tomography, respectively.
Myocardial glucose uptake was significantly decreased in subjects with T2DM compared to the NGT or prediabetes groups (p for trend = 0.001). Multivariate linear regression analyses revealed that visceral fat area (β = -0.22, p = 0.018), fasting FFA (β = -0.39, p < 0.001), and uric acid levels (β = -0.21, p = 0.007) were independent determinants of myocardial glucose uptake. Multiple logistic analyses demonstrated that decreased myocardial glucose uptake (OR 2.32; 95% CI 1.02-5.29, p = 0.045) and visceral fat area (OR 1.02, 95% CI 1.01-1.03, p = 0.018) were associated with T2DM.
Our findings indicate visceral adiposity is strongly associated with the alteration of myocardial glucose uptake evaluated by (18)FDG-PET, and its association further relates to T2DM.
心脏需要持续的能量来源，主要来自游离脂肪酸（FFA）和葡萄糖。糖尿病患者心脏会发生心肌底物代谢改变，但其与其他代谢变量的具体关联仍不清楚。我们旨在使用[（18）F] - 氟脱氧葡萄糖 - 正电子发射断层扫描（（18）FDG - PET）结合内脏和皮下脂肪量以及代谢实验室参数，评估葡萄糖耐量正常（NGT）、糖尿病前期和2型糖尿病（T2DM）患者心脏的葡萄糖摄取情况。
在一家三级医院的健康促进中心招募了346名个体（NGT，n = 76；糖尿病前期，n = 208；T2DM，n = 62）。分别使用（18）FDG - PET和腹部计算机断层扫描评估空腹心肌葡萄糖摄取以及内脏和皮下脂肪面积。
与NGT或糖尿病前期组相比，T2DM患者的心肌葡萄糖摄取显著降低（趋势p = 0.001）。多变量线性回归分析显示，内脏脂肪面积（β = -0.22，p = 0.018）、空腹FFA（β = -0.39，p < 0.001）和尿酸水平（β = -0.21，p = 0.007）是心肌葡萄糖摄取的独立决定因素。多因素逻辑分析表明，心肌葡萄糖摄取降低（OR 2.32；95% CI 1.02 - 5.29，p = 0.045）和内脏脂肪面积（OR 1.02，95% CI 1.01 - 1.03，p = 0.018）与T2DM相关。
我们的研究结果表明，内脏脂肪过多与通过（18）FDG - PET评估的心肌葡萄糖摄取改变密切相关，且这种关联与T2DM进一步相关。
