期刊
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
卷 68, 期 1, 页码 53-63出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jacc.2016.03.597
关键词
diabetic cardiomyopathy; epicardial fat deposition; fatty liver disease; magnetic resonance imaging; magnetic resonance spectroscopy
资金
- Oxford Partnership Comprehensive Biomedical Research Centre
- Department of Health's National Institute for Health Research Biomedical Research Centers
- Sir Henry Dale Fellowship - Welcome Trust
- Sir Henry Dale Fellowship - Royal Society [098436/Z/12/Z]
- Sanofi
- Oxford British Heart Foundation Centre of Research Excellence
- Wellcome Trust [098436/Z/12/Z] Funding Source: Wellcome Trust
- British Heart Foundation [FS/12/32/29559] Funding Source: researchfish
- National Institute for Health Research [NF-SI-0512-10005, CL-2015-11-001] Funding Source: researchfish
BACKGROUND Type 2 diabetes (T2D) and obesity are associated with nonalcoholic fatty liver disease, cardiomyopathy, and cardiovascular mortality. Both show stronger links between ectopic and visceral fat deposition, and an increased cardiometabolic risk compared with subcutaneous fat. OBJECTIVES This study investigated whether lean patients (Ln) with T2D exhibit increased ectopic and visceral fat deposition and whether these are linked to cardiac and hepatic changes. METHODS Twenty-seven obese patients (Ob) with T2D, 15 Ln-T2D, and 12 normal-weight control subjects were studied. Subjects underwent cardiac computed tomography, cardiac magnetic resonance imaging (MRI), proton and phosphorus MR spectroscopy, and multiparametric liver MR, including hepatic proton MRS, T-1-and T-2*-mapping yielding iron-corrected T-1 [cT(1)]. RESULTS Diabetes, with or without obesity, was associated with increased myocardial triglyceride content (p = 0.01), increased hepatic triglyceride content (p = 0.04), and impaired myocardial energetics (p = 0.04). Although cardiac structural changes, steatosis, and energetics were similar between the T2D groups, epicardial fat (p = 0.04), hepatic triglyceride (p = 0.01), and insulin resistance (p = 0.03) were higher in Ob-T2D. Epicardial fat, hepatic triglyceride, and insulin resistance correlated negatively with systolic strain and diastolic strain rates, which were only significantly impaired in Ob-T2D (p < 0.001 and p = 0.006, respectively). Fibroinflammatory liver disease (elevated cT1) was only evident in Ob-T2D patients. cT(1) correlated with hepatic and epicardial fat (p < 0.001 and p = 0.01, respectively). CONCLUSIONS Irrespective of body mass index, diabetes is related to significant abnormalities in cardiac structure, energetics, and cardiac and hepatic steatosis. Obese patients with T2D show a greater propensity for ectopic and visceral fat deposition. (C) 2016 by the American College of Cardiology Foundation. Published by Elsevier.
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