Tissue sodium content in patients with type 2 diabetes mellitus

Background: Tissue sodium content by Na-23 magnetic resonance imaging (MRI) has been found to be increased in arterial hypertension. We analyzed whether tissue sodium content is increased in patients with type-2 diabetes (T2DM). Methods: Patients with T2DM were compared to those with primary hypertension. Patients with T2DM were off any antidiabetic and hypertensive patients off any antihypertensive therapy for at least 4 weeks. Skin and muscle sodium content was assessed non-invasively with a 3.0 T clinical MRI system (Magnetom Verio, Siemens Health Care, Erlangen, Germany) in each patient. Results: In patients with T2DM (N = 59) we observed significantly greater muscle sodium content (diabetes: 20.6 +/- 3.5 vs hypertension: 16.3 +/- 2.5 mmol/l, p < 0.001) and skin sodium content (diabetes: 24.5 +/- 7.2 vs hypertension: 20.6 5.7 mmol/l, p = 0.01) than in those with primary hypertension (N = 33). When potential confounders (age, body mass index, gender, systolic and diastolic blood pressure, estimated glomerular filtration rate) were entered in a covariance analysis, both skin sodium content (p = 0.037) and muscle sodium content (p < 0.001) were still clearly elevated. Conclusion: Patients with T2DM have greater skin and muscle sodium content. These are the first known data to demonstrate increased tissue sodium content in patients with T2DM, measured by Na-23 magnetic resonance imaging. Since tissue sodium content is related to organ damage, therapeutic intervention should aim at reducing tissue sodium content. (C) 2019 Elsevier Inc. All rights reserved.