title: Abnormal left ventricular energy metabolism in obese men with preserved systolic and diastolic functions is associated with insulin resistance.
abstract: OBJECTIVE
  Perturbations in cardiac energy metabolism might represent early alterations in diabetes preceding functional and pathological changes. We evaluated left ventricular (LV) structure/geometry and function in relation to energy metabolism and cardiovascular risk factors in overweight/obese men using magnetic resonance techniques.
  
  
  METHODS
  We studied 81 healthy men (aged 22-55 years, with BMI between 19 and 35 kg/m2) by means of cardiac magnetic resonance imaging and 31P-magnetic resonance spectroscopy in the resting and fasted conditions and stratified them in quartiles of BMI (cut offs: 23.2, 25.5 and 29.0 kg/m2).
  
  
  RESULTS
  LV mass increased across quartiles of BMI; meanwhile, the volumes did not differ. Parameters of LV systolic and diastolic function were not different among quartiles. The phosphocreatine-to-ATP ratio was reduced across increasing quartiles of mean +/- SD BMI (2.25 +/- 0.52, 1.89 +/- 0.26, 1.99 +/- 0.38, and 1.79 +/- 0.29; P < 0.006) in association with insulin sensitivity (computer homeostasis model assessment 2 model); this relation was independent of age, BMI, blood pressure, wall mass, HDL cholesterol, triglycerides, smoking habits, and metabolic syndrome.
  
  
  CONCLUSIONS
  Abnormal LV energy metabolism was detectable in obese men in the presence of normal function, supporting the hypothesis that metabolic remodeling in insulin resistant states precedes functional and structural/geometrical remodeling of the heart regardless of the onset of overt hyperglycemia.
authors: Section of Nutrition/Metabolism, Department of Internal Medicine, Istituto Scientifico San Raffaele, Milano, Italy. perseghin.gianluca@hsr.it
authors: Gianluca
authors: G
authors: Perseghin
authors: Georgia
authors: G
authors: Ntali
authors: Francesco
authors: F
authors: De Cobelli
authors: Guido
authors: G
authors: Lattuada
authors: Antonio
authors: A
authors: Esposito
authors: Elena
authors: E
authors: Belloni
authors: Tamara
authors: T
authors: Canu
authors: Federica
authors: F
authors: Costantino
authors: Francesca
authors: F
authors: Ragogna
authors: Paola
authors: P
authors: Scifo
authors: Alessandro
authors: A
authors: Del Maschio
authors: Livio
authors: L
authors: Luzi
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D049628:Body Size; D003971:Diastole / Q000502:physiology*; D004734:Energy Metabolism; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance / Q000502:physiology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000503:physiopathology*; D012016:Reference Values; D013599:Systole / Q000502:physiology*; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000378:metabolism*
chemical_list: D001786:Blood Glucose; D007328:Insulin