Contribution of glucose tolerance and gender to cardiac adiposity.
OBJECTIVE
To examine whether pericardial and myocardial fat depots may contribute to the association between diabetes and cardiovascular risk, including sex-related differences, and the role of adiponectin, we evaluated data in patients with obesity and without diabetes [nondiabetic (ND)] or with impaired glucose tolerance or type 2 diabetes and in lean ND controls.


METHODS
Magnetic resonance imaging and spectroscopy were used to measure left ventricular (LV) function and abdominal sc and visceral fat areas to estimate respective masses, pericardial fat depots, and myocardial triglyceride content in 53 subjects (10 lean ND, 25 obese ND, six impaired-glucose-tolerance, and 12 type 2 diabetic patients with macrovascular disease); gender effects and adiponectin levels were evaluated in the available subset of subjects.


RESULTS
Myocardial and pericardial fat increased progressively across study groups. They were lower in obese women than men (P = 0.002), but cardiac steatosis caught up in hyperglycemic women (+81% vs. ND, P = 0.01). Adiponectin was inversely related with both fat depots (P < 0.01) and LV mass (P = 0.003) and positively with LV function (P = 0.03). In multiple regression analysis, myocardial and pericardial fat were independently related with plasma glucose levels, only pericardial fat mass was associated with visceral adiposity and myocardial fat with cardiac output and work.


CONCLUSIONS
We conclude that glycemia, gender, adiponectin, and cardiac workload are associated with, and hyperglycemia and male gender are independent positive predictors of, heart adiposity. Once glucose tolerance becomes impaired, the evolution of cardiac steatosis is more pronounced in women.
Iozzo
Patricia
P
Turku PET Centre, University of Turku, 20521 Turku, Finland. patricia.iozzo@ifc.cnr.it
Lautamaki
Riikka
R
Borra
Ronald
R
Lehto
Hanna-Riikka
HR
Bucci
Marco
M
Viljanen
Antti
A
Parkka
Jussi
J
Lepomaki
Virva
V
Maggio
Romina
R
Parkkola
Riitta
R
Knuuti
Juhani
J
Nuutila
Pirjo
P
D000273:Adipose Tissue / Q000033:anatomy & histology*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000473:pathology; D005260:Female; D018149:Glucose Intolerance / Q000097:blood* / Q000473:pathology; D005951:Glucose Tolerance Test; D006321:Heart / Q000033:anatomy & histology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D009206:Myocardium / Q000378:metabolism; D009765:Obesity / Q000097:blood* / Q000473:pathology; D014280:Triglycerides / Q000378:metabolism; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology; D016277:Ventricular Function, Left / Q000502:physiology
D014280:Triglycerides