Effects of Insulin Therapy on Myocardial Lipid Content and Cardiac Geometry in Patients with Type-2 Diabetes Mellitus |
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| Authors: | Drazenka Jankovic Yvonne Winhofer Miriam Promintzer-Schifferl Evelyne Wohlschl?ger-Krenn Christian Heinz Anderwald Peter Wolf Thomas Scherer Gert Reiter Siegfried Trattnig Anton Luger Michael Krebs Martin Krssak |
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| Institution: | 1Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria;2Metabolic Unit, ISIB CNR, Padova, Italy;3Agathenhof, Specialized Hospital for Metabolic Diseases, Micheldorf, Austria;4Siemens Healthcare, Graz, Austria;5Department of Radiodiagnostics, Centre of Excellence High-Field MR, Medical University of Vienna, Vienna, Austria;Clermont Université, France |
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| Abstract: | Aims/HypothesisRecent evidence suggests a link between myocardial steatosis and diabetic cardiomyopathy. Insulin, as a lipogenic and growth-promoting hormone, might stimulate intramyocardial lipid (MYCL) deposition and hypertrophy. Therefore, the aim of the present study was to investigate the short-term effects of insulin therapy (IT) on myocardial lipid content and morphology in patients with T2DM.MethodsEighteen patients with T2DM were recruited (age 56±2 years; HbA1c: 10.5±0.4%). In 10 patients with insufficient glucose control under oral medication IT was initiated due to secondary failure of oral glucose lowering therapy (IT-group), while 8 individuals did not require additional insulin substitution (OT-group). In order to assess MYCL and intrahepatic lipid (IHLC) content as well as cardiac geometry and function magnetic resonance spectroscopy (MRS) and imaging (MRI) examinations were performed at baseline (IT and OT) and 10 days after initiation of IT. Follow up measurements took place 181±49 days after IT.ResultsInterestingly, basal MYCLs were 50% lower in IT- compared to OT-group (0.41±0.12 vs. 0.80±0.11% of water signal; p?=?0.034). After 10 days of IT, an acute 80%-rise in MYCL (p?=?0.008) was observed, while IHLC did not change. Likewise, myocardial mass (+13%; p?=?0.004), wall thickness in end-diastole (+13%; p?=?0.030) and concentricity, an index of cardiac remodeling, increased (+28%; p?=?0.026). In the long-term MYCL returned to baseline, while IHCL significantly decreased (?31%; p?=?0.000). No acute changes in systolic left ventricular function were observed.Conclusions/InterpretationThe initiation of IT in patients with T2DM was followed by an acute rise in MYCL concentration and myocardial mass. |
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