2087 Metabolic imaging in diabetes: modulating non-esterified fatty acids
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KeywordsLeave Ventricular Ejection Fraction Diastolic Function Caloric Restriction Myocardial Function Proton Magnetic Resonance Spectroscopy
In type 2 diabetes mellitus (DM2) plasma levels of non-esterified fatty acids (NEFA) are increased. Changes in plasma levels of NEFA are associated with changes in myocardial triglyceride (TG) content and with changes in myocardial function in healthy subjects. Whether this flexibility of myocardial TG can also be induced in DM2 is yet unknown.
To determine in uncomplicated DM2 whether different levels of plasma NEFA induce changes in myocardial TG content and myocardial function.
Materials and methods
Myocardial TG content and left ventricular (LV) function were determined using proton magnetic resonance spectroscopy and MRI respectively at 1.5 T (Gyroscan ACS/NT15, Philips) in 9 subjects with uncomplicated DM2 (mean age ± SE: 58.9 ± 1.6 yrs, BMI 26.4 ± 1.0 kg/m2, HbA1c: 6.0 ± 0.2%) before and after 3 days of a very low calorie diet (VLCD, 473 kcal/day, to increase plasma levels of NEFA) and after 3 days of a VLCD complemented with the administration of acipimox (4 × 250 mg during the last day of caloric restriction, to decrease plasma levels of NEFA). The percentage (%) of myocardial TG was calculated as TG/water × 100. Myocardial function was calculated as ejection fraction (EF) for systolic function, and the ratio between early and atrial filling phase (E/A ratio) for diastolic function.
A short-term VLCD induces myocardial TG accumulation in patients with uncomplicated DM2, and is associated with changes in diastolic function. Administration of acipimox during the VLCD reduced myocardial TG accumulation together with plasma levels of NEFA and showed no effects on diastolic heart function. These data stress the relevance of elevated levels of NEFA in DM2.
This article is published under license to BioMed Central Ltd.