Reduction in Global Myocardial Glucose Metabolism in Subjects With 1-Hour Postload Hyperglycemia and Impaired Glucose Tolerance.

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  • Additional Information
    • Source:
      Publisher: American Diabetes Association Country of Publication: United States NLM ID: 7805975 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1935-5548 (Electronic) Linking ISSN: 01495992 NLM ISO Abbreviation: Diabetes Care Subsets: MEDLINE
    • Publication Information:
      Publication: Alexandria Va : American Diabetes Association
      Original Publication: New York, American Diabetes Assn.
    • Subject Terms:
      Carbohydrate Metabolism*; Glucose/*metabolism ; Glucose Intolerance/*metabolism ; Hyperglycemia/*metabolism ; Myocardium/*metabolism; Adult ; Blood Glucose/metabolism ; Diabetes Mellitus, Type 2/etiology ; Diabetes Mellitus, Type 2/metabolism ; Down-Regulation ; Fasting/metabolism ; Female ; Glucose/pharmacokinetics ; Glucose Clamp Technique ; Glucose Intolerance/blood ; Glucose Intolerance/complications ; Glucose Tolerance Test/methods ; Humans ; Hyperglycemia/blood ; Hyperglycemia/complications ; Insulin/metabolism ; Insulin Resistance/physiology ; Male ; Middle Aged ; Risk Factors ; Time Factors
    • Abstract:
      Objective: Impaired insulin-stimulated myocardial glucose uptake has occurred in patients with type 2 diabetes with or without coronary artery disease. Whether cardiac insulin resistance is present remains uncertain in subjects at risk for type 2 diabetes, such as individuals with impaired glucose tolerance (IGT) or those with normal glucose tolerance (NGT) and 1-h postload glucose ≥155 mg/dL during an oral glucose tolerance test (NGT 1-h high). This issue was examined in this study.
      Research Design and Methods: The myocardial metabolic rate of glucose (MRGlu) was measured by using dynamic 18 F-fluorodeoxyglucose positron emission tomography combined with a euglycemic-hyperinsulinemic clamp in 30 volunteers without coronary artery disease. Three groups were studied: 1 ) those with 1-h postload glucose <155 mg/dL (NGT 1-h low) ( n = 10), 2 ) those with NGT 1-h high ( n = 10), 3 ) and those with IGT ( n = 10).
      Results: After adjusting for age, sex, and BMI, both subjects with NGT 1-h high (23.7 ± 6.4 mmol/min/100 mg; P = 0.024) and those with IGT (16.4 ± 6.0 mmol/min/100 mg; P < 0.0001) exhibited a significant reduction in global myocardial MRGlu; this value was 32.8 ± 9.7 mmol/min/100 mg in subjects with NGT 1-h low. Univariate correlations showed that MRGlu was positively correlated with insulin-stimulated whole-body glucose disposal ( r = 0.441; P = 0.019) and negatively correlated with 1-h ( r = -0.422; P = 0.025) and 2-h ( r = -0.374; P = 0.05) postload glucose levels, but not with fasting glucose.
      Conclusions: This study shows that myocardial insulin resistance is an early defect that is already detectable in individuals with dysglycemic conditions associated with an increased risk of type 2 diabetes, such as IGT and NGT 1-h high.
      (© 2020 by the American Diabetes Association.)
    • Accession Number:
      0 (Blood Glucose)
      0 (Insulin)
      IY9XDZ35W2 (Glucose)
    • Publication Date:
      Date Created: 20200125 Date Completed: 20201204 Latest Revision: 20201214
    • Publication Date:
      20240829
    • Accession Number:
      10.2337/dc19-1975
    • Accession Number:
      31974102