Cardiopulmonary fitness, insulin sensitivity and myocardial fat: a CMR/MRS study in obese non-diabetic women
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KeywordsInsulin Sensitivity Diastolic Function Insulin Sensitivity Index Peak Filling Rate Cardiopulmonary Fitness
Obesity predisposes to heart failure, particularly in sedentary subjects. Among others, alterations in myocardial substrate metabolism, myocardial triglyceride (MTG) accumulation and lipotoxicity may be involved. MTG is excessive in overt diabetes and related to diastolic dysfunction. In men, exercise training improves MTG, cardiac performance, physical fitness and insulin sensitivity. Given the gender difference in metabolic response to obesity these results cannot be simply extrapolated to women. Thus, it was the objective to explore the relation between cardiorespiratory fitness, cardiac function, and MTG in obese women.
In contrast, triglyceride levels in the skeletal muscle did not correlate to cardiopulmonary fitness in the study group (p>0.05), but correlated negatively with insulin sensitivity (r=-0.32, p=0.02).
In overweight and obese women, reduced cardiopulmonary fitness is associated with increased myocardial triglyceride content. Prediabetic glucose tolerance in obese females is associated with higher MTG and reduced diastolic function. Exercise-based life-style interventions could have a beneficial effect on cardiac function through myocardial triglyceride mobilization.
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