title: Myocardial steatosis, cardiac remodelling and fitness in insulin-sensitive and insulin-resistant obese women.
abstract: BACKGROUND
  Obesity predisposes to heart failure and premature cardiovascular death, particularly in sedentary women. In animal models and in men with type 2 diabetes mellitus, impaired cardiac function is associated with myocardial triglyceride (MTG) accumulation. Lipotoxic injury from altered myocardial metabolism may be causative. Whether such association also exists in obese, non-diabetic women is unknown.
  
  
  OBJECTIVE
  To explore the relation between MTG content, cardiac remodelling and cardiorespiratory fitness in obese, insulin-sensitive and insulin-resistant non-diabetic women.
  
  
  METHODS
  Cross-sectional investigation.
  
  
  METHODS
  Academic clinical research centre.
  
  
  METHODS
  65 Overweight/obese and sedentary, but otherwise healthy women (body mass index 33±4 kg/m(2); age 45±10 years).
  
  
  METHODS
  None.
  
  
  METHODS
  Cardiac structure and function measured by cardiovascular magnetic resonance imaging and MTG content of the interventricular septum by (1)H MR spectroscopy. Additional outcomes were cardiopulmonary fitness and insulin sensitivity during oral glucose tolerance testing.
  
  
  RESULTS
  Insulin resistance (composite insulin sensitivity index (C-ISI) <4.6) was present in 29 women. MTG content was higher (0.83±0.30 vs 0.61±0.23, p=0.002) and left ventricular diastolic (p<0.01), but not systolic function was reduced in women with insulin resistance compared with insulin-sensitive women. The remodelling index defined as left ventricular mass divided by end-diastolic volume was increased in women with impaired glucose tolerance (p=0.006). Furthermore, cardiopulmonary fitness was equal in both groups, but was inversely correlated with MTG (r=-0.28, p=0.02).
  
  
  CONCLUSIONS
  In overweight and obese women, insulin resistance is associated with increased MTG content, cardiac remodelling and reduced diastolic function.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT00956566.
authors.affiliation: Working Group Cardiac MR Medical Faculty of the Charité Campus Buch and HELIOS Klinikum Berlin Buch, Berlin, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Utz
authors.forename: Stefan
authors.initials: S
authors.lastname: Engeli
authors.forename: Sven
authors.initials: S
authors.lastname: Haufe
authors.forename: Petra
authors.initials: P
authors.lastname: Kast
authors.forename: Mario
authors.initials: M
authors.lastname: Hermsdorf
authors.forename: Susanne
authors.initials: S
authors.lastname: Wiesner
authors.forename: Martin
authors.initials: M
authors.lastname: Pofahl
authors.forename: Julius
authors.initials: J
authors.lastname: Traber
authors.forename: Friedrich C
authors.initials: FC
authors.lastname: Luft
authors.forename: Michael
authors.initials: M
authors.lastname: Boschmann
authors.forename: Jeanette
authors.initials: J
authors.lastname: Schulz-Menger
authors.forename: Jens
authors.initials: J
authors.lastname: Jordan
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D009202:Cardiomyopathies / Q000209:etiology* / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D003430:Cross-Sectional Studies; D005080:Exercise Test; D005260:Female; D005858:Germany; D005951:Glucose Tolerance Test; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism*; D009765:Obesity / Q000150:complications* / Q000378:metabolism / Q000503:physiopathology; D010809:Physical Fitness; D012044:Regression Analysis; D018570:Risk Assessment; D012307:Risk Factors; D057185:Sedentary Behavior; D014280:Triglycerides / Q000378:metabolism*; D018487:Ventricular Dysfunction, Left / Q000209:etiology* / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D016277:Ventricular Function, Left; D020257:Ventricular Remodeling
chemical_list: D001786:Blood Glucose; D007328:Insulin; D014280:Triglycerides