Insights into Insulin Resistance and Calcification in the Myocardium in Type 2 Diabetes : A Coronary Artery Analysis
Martín-Saladich, Queralt (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Simó Canonge, Rafael (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Aguadé-Bruix, Santiago (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Simó-Servat, Olga (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Aparicio-Gómez, Carolina (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Hernández, Cristina (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Ramirez-Serra, Clara (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Pizzi, María Nazarena (Universitat de Barcelona. Departament de Medicina)
Roque, Albert (Hospital Universitari Vall d'Hebron. Institut de Recerca)
González Ballester, Miguel A. (Universitat Pompeu Fabra)
Herance, José Raul (Hospital Universitari Vall d'Hebron. Institut de Recerca)

Fecha:	2023
Resumen:	Type 2 diabetes (T2D) is responsible for high incidence of cardiovascular (CV) complications leading to heart failure. Coronary artery region-specific metabolic and structural assessment could provide deeper insight into the extent of the disease and help prevent adverse cardiac events. Therefore, in this study, we aimed at investigating such myocardial dynamics for the first time in insulin-sensitive (mIS) and insulin-resistant (mIR) T2D patients. We targeted global and region-specific variations using insulin sensitivity (IS) and coronary artery calcifications (CACs) as CV risk factor in T2D patients. IS was computed using myocardial segmentation approaches at both baseline and after an hyperglycemic-insulinemic clamp (HEC) on [ 18 F]FDG-PET images using the standardized uptake value (SUV) (ΔSUV = SUV − SUV) and calcifications using CT Calcium Scoring. Results suggest that some communicating pathways between response to insulin and calcification are present in the myocardium, whilst differences between coronary arteries were only observed in the mIS cohort. Risk indicators were mostly observed for mIR and highly calcified subjects, which supports previously stated findings that exhibit a distinguished exposure depending on the impairment of response to insulin, while projecting added potential complications due to arterial obstruction. Moreover, a pattern relating calcification and T2D phenotypes was observed suggesting the avoidance of insulin treatment in mIS but its endorsement in mIR subjects. The right coronary artery displayed more ΔSUV, whilst plaque was more present in the circumflex. However, differences between phenotypes, and therefore CV risk, were associated to left descending artery (LAD) translating into higher CACs regarding IR, which could explain why insulin treatment was effective for LAD at the expense of higher likelihood of plaque accumulation. Personalized approaches to assess T2D may lead to more efficient treatments and risk-prevention strategies.
Ayudas:	Instituto de Salud Carlos III PI20/01588 Instituto de Salud Carlos III FI21/00304
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Myocardium ; Insulin sensibility ; Type 2 diabetes ; [ 18 F]FDG-PET imaging ; Cardiovascular risk ; Coronary artery ; Metabolic disease ; Computed tomography ; Calcification
Publicado en:	International journal of molecular sciences, Vol. 24 (february 2023) , ISSN 1422-0067

DOI: 10.3390/ijms24043250
PMID: 36834662

15 p, 1.0 MB

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