title: Myocardial Fat Accumulation Is Independent of Measures of Insulin Sensitivity.
abstract: BACKGROUND
  Myocardial steatosis, an independent predictor of diastolic dysfunction, is frequently present in type 2 diabetes mellitus. High free fatty acid flux, hyperglycemia, and hyperinsulinemia may play a role in myocardial steatosis. There are no prior studies examining the relationship between insulin sensitivity (antilipolytic and glucose disposal actions of insulin) and cardiac steatosis.
  
  
  OBJECTIVE
  Using a cross-sectional study design of individuals with and without metabolic syndrome (MetSyn), we examined the relationships between cardiac steatosis and the sensitivity of the antilipolytic and glucose disposal actions of insulin.
  
  
  METHODS
  Pericardial fat (PF) volume, intramyocardial and hepatic fat (MF and HF) content, visceral fat (VF) and sc fat content were assessed by magnetic resonance imaging in 77 subjects (49 without MetSyn and 28 with MetSyn). In a subset of the larger cohort (n = 52), peripheral insulin sensitivity index (SI) and adipocyte insulin sensitivity (Adipo-SI) were determined from an insulin-modified frequently sampled iv glucose tolerance test. The Quantitative Insulin Sensitivity Check Index was used as a surrogate for hepatic insulin sensitivity.
  
  
  RESULTS
  Individuals with the MetSyn had significantly higher body mass index, total body fat, and MF, PF, HF, and VF content. HF and VF, but not MF, were negatively correlated with the Quantitative Insulin Sensitivity Check Index, Adipo-SI, and SI. Stepwise regression revealed that waist circumference and serum triglyceride levels independently predicted MF and PF, respectively. Adipo-SI and serum triglyceride levels independently predict HF.
  
  
  CONCLUSIONS
  Myocardial steatosis is unrelated to hepatic, adipocyte, or peripheral insulin sensitivity. Although it is frequently observed in insulin-resistant subjects, further studies are necessary to identify and delineate pathogenic mechanisms that differentially affect cardiac and hepatic steatosis.
authors.affiliation: Diabetes, Endocrinology, and Obesity Branch (R.Mu., E.Y.L., R.Ma., B.S.A., K.M., M.F.W., M.C.S.) and Biomedical and Metabolic Imaging Branch (R.N., R.O., A.M.G.), National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland 20892.
authors.forename: Ranganath
authors.initials: R
authors.lastname: Muniyappa
authors.affiliation: Diabetes, Endocrinology, and Obesity Branch (R.Mu., E.Y.L., R.Ma., B.S.A., K.M., M.F.W., M.C.S.) and Biomedical and Metabolic Imaging Branch (R.N., R.O., A.M.G.), National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland 20892.
authors.forename: Radwa
authors.initials: R
authors.lastname: Noureldin
authors.affiliation: Diabetes, Endocrinology, and Obesity Branch (R.Mu., E.Y.L., R.Ma., B.S.A., K.M., M.F.W., M.C.S.) and Biomedical and Metabolic Imaging Branch (R.N., R.O., A.M.G.), National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland 20892.
authors.forename: Ronald
authors.initials: R
authors.lastname: Ouwerkerk
authors.affiliation: Diabetes, Endocrinology, and Obesity Branch (R.Mu., E.Y.L., R.Ma., B.S.A., K.M., M.F.W., M.C.S.) and Biomedical and Metabolic Imaging Branch (R.N., R.O., A.M.G.), National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland 20892.
authors.forename: Elizabeth Y
authors.initials: EY
authors.lastname: Liu
authors.affiliation: Diabetes, Endocrinology, and Obesity Branch (R.Mu., E.Y.L., R.Ma., B.S.A., K.M., M.F.W., M.C.S.) and Biomedical and Metabolic Imaging Branch (R.N., R.O., A.M.G.), National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland 20892.
authors.forename: Ritu
authors.initials: R
authors.lastname: Madan
authors.affiliation: Diabetes, Endocrinology, and Obesity Branch (R.Mu., E.Y.L., R.Ma., B.S.A., K.M., M.F.W., M.C.S.) and Biomedical and Metabolic Imaging Branch (R.N., R.O., A.M.G.), National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland 20892.
authors.forename: Brent S
authors.initials: BS
authors.lastname: Abel
authors.affiliation: Diabetes, Endocrinology, and Obesity Branch (R.Mu., E.Y.L., R.Ma., B.S.A., K.M., M.F.W., M.C.S.) and Biomedical and Metabolic Imaging Branch (R.N., R.O., A.M.G.), National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland 20892.
authors.forename: Katherine
authors.initials: K
authors.lastname: Mullins
authors.affiliation: Diabetes, Endocrinology, and Obesity Branch (R.Mu., E.Y.L., R.Ma., B.S.A., K.M., M.F.W., M.C.S.) and Biomedical and Metabolic Imaging Branch (R.N., R.O., A.M.G.), National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland 20892.
authors.forename: Mary F
authors.initials: MF
authors.lastname: Walter
authors.affiliation: Diabetes, Endocrinology, and Obesity Branch (R.Mu., E.Y.L., R.Ma., B.S.A., K.M., M.F.W., M.C.S.) and Biomedical and Metabolic Imaging Branch (R.N., R.O., A.M.G.), National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland 20892.
authors.forename: Monica C
authors.initials: MC
authors.lastname: Skarulis
authors.affiliation: Diabetes, Endocrinology, and Obesity Branch (R.Mu., E.Y.L., R.Ma., B.S.A., K.M., M.F.W., M.C.S.) and Biomedical and Metabolic Imaging Branch (R.N., R.O., A.M.G.), National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland 20892.
authors.forename: Ahmed M
authors.initials: AM
authors.lastname: Gharib
mesh_terms: D000273:Adipose Tissue / Q000378:metabolism*; D050154:Adiposity / Q000502:physiology; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism / Q000503:physiopathology; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008099:Liver / Q000378:metabolism; D008297:Male; D024821:Metabolic Syndrome / Q000378:metabolism / Q000503:physiopathology; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism*; D009765:Obesity / Q000378:metabolism / Q000503:physiopathology; D010496:Pericardium / Q000378:metabolism; D016277:Ventricular Function, Left