Cardiac Insulin Resistance in Subjects With Metabolic Syndrome Traits and Early Subclinical Atherosclerosis

Experimental evidence suggests that metabolic syndrome (MetS) is associated with changes in cardiac metabolism. Whether this association occurs in humans is unknown. 821 asymptomatic individuals from the Progression of Early Subclinical Atherosclerosis (PESA) study (50.6 [46.9-53.6] years, 83.7% mal...

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Bibliographic Details
Authors: Devesa, Ana, Fuster, Valentin, Vazirani, Ravi, García-Lunar, Inés, Oliva, Belén, España, Samuel, Moreno-Arciniegas, Andrea, Sanz, Javier, Perez-Herreras, Cristina, Bueno, Héctor, Lara-Pezzi, Enrique, García-Alvarez, Ana, Martínez de Vega, Vicente, Fernández-Friera, Leticia, Trivieri, Maria G, Fernández-Ortiz, Antonio, Rosselló, Xavier, Sánchez-González, Javier, Ibanez, Borja
Format: article
Publication Date:2023
Country:España
Institution:Conselleria de Salut i Consum del Govern de les Illes Balears
Repository:Docusalut
Language:English
OAI Identifier:oai:docusalut.com:20.500.13003/20271
Online Access:https://hdl.handle.net/20.500.13003/20271
Access Level:Open access
Keyword:Metabolic Syndrome
Radiopharmaceuticals
Male
Positron-Emission Tomography
Female
Atherosclerosis
Humans
Insulin Resistance
Fluorodeoxyglucose F18
Heart
Aterosclerosis
Fluorodesoxiglucosa F18
Humanos
Síndrome Metabólico
Radiofármacos
Femenino
Resistencia a la Insulina
Corazón
Masculino
Tomografía de Emisión de Positrones
Description
Summary:Experimental evidence suggests that metabolic syndrome (MetS) is associated with changes in cardiac metabolism. Whether this association occurs in humans is unknown. 821 asymptomatic individuals from the Progression of Early Subclinical Atherosclerosis (PESA) study (50.6 [46.9-53.6] years, 83.7% male) underwent two whole-body 18F-fluorodeoxyglucose positron emission tomography-magnetic resonance (18F-FDG PET-MR) 4.8 ± 0.6 years apart. Presence of myocardial 18F-FDG uptake was evaluated qualitatively and quantitatively. No myocardial uptake was grade 0, while positive uptake was classified in grades 1-3 according to target-to-background ratio tertiles. One hundred fifty-six participants (19.0%) showed no myocardial 18F-FDG uptake, and this was significantly associated with higher prevalence of MetS (29.0% vs. 13.9%, P < 0.001), hypertension (29.0% vs. 18.0%, P = 0.002), and diabetes (11.0% vs. 3.2%, P < 0.001), and with higher insulin resistance index (HOMA-IR, 1.64% vs. 1.23%, P < 0.001). Absence of myocardial uptake was associated with higher prevalence of early atherosclerosis (i.e., arterial 18F-FDG uptake, P = 0.004). On follow-up, the associations between myocardial 18F-FDG uptake and risk factors were replicated, and MetS was more frequent in the group without myocardial uptake. The increase in HOMA-IR was associated with a progressive decrease in myocardial uptake (P < 0.001). In 82% of subjects, the categorization according to presence/absence of myocardial 18F-FDG uptake did not change between baseline and follow-up. MetS regression on follow-up was associated with a significant (P < 0.001) increase in myocardial uptake. Apparently healthy individuals without cardiac 18F-FDG uptake have higher HOMA-IR and higher prevalence of MetS traits, cardiovascular risk factors, and early atherosclerosis. An improvement in cardiometabolic profile is associated with the recovery of myocardial 18F-FDG uptake at follow-up.

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