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Cardiac structure and function are altered in type 2 diabetes and Non-alcoholic fatty liver disease and associate with glycemic control

Lookup NU author(s): Dr Sophie Cassidy, Dr Kate Hallsworth, Dr Christian Thoma, Dr Guy MacGowan, Dr Kieren Hollingsworth, Professor Chris Day, Professor Roy Taylor, Dr Djordje Jakovljevic, Professor Michael Trenell

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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Abstract

Background: Both non-alcoholic fatty liver disease (NAFLD) and Type 2 diabetes increase the risk of developing cardiovascular disease. The metabolic processes underlying NAFLD and Type 2 diabetes are part of an integrated mechanism but little is known about how these conditions may differentially affect the heart. We compared the impact of NAFLD and Type 2 diabetes on cardiac structure, function and metabolism.Methods: 19 adults with Type 2 diabetes (62 +/- 8 years), 19 adults with NAFLD (54 +/- 15 years) and 19 healthy controls (56 +/- 14 years) underwent assessment of cardiac structure, function and metabolism using high resolution magnetic resonance imaging, tagging and spectroscopy at 3.0 T.Results: Adults with NAFLD and Type 2 diabetes demonstrate concentric remodelling with an elevated eccentricity ratio compared to controls (1.05 +/- 0.3 vs. 1.12 +/- 0.2 vs. 0.89 +/- 0.2 g/ml; p < 0.05). Despite this, only the Type 2 diabetes group demonstrate significant systolic and diastolic dysfunction evidenced by a reduced stroke index (31 +/- 7vs. controls, 38 +/- 10, p < 0.05 ml/m(2)) and reduced E/A (0.9 +/- 0.4 vs. controls, 1.9 +/- 1.4, p < 0.05) respectively. The torsion to shortening ratio was higher in Type 2 diabetes compared to NAFLD (0.58 +/- 0.16 vs. 0.44 +/- 0.13; p < 0.05). Significant associations were observed between fasting blood glucose/HbA1c and diastolic parameters as well as the torsion to shortening ratio (all p < 0.05). Phosphocreatine/adenosine triphosphate ratio was not altered in NAFLD or Type 2 diabetes compared to controls.Conclusions: Changes in cardiac structure are evident in adults with Type 2 diabetes and NAFLD without overt cardiac disease and without changes in cardiac energy metabolism. Only the Type 2 diabetes group display diastolic and subendocardial dysfunction and glycemic control may be a key mediator of these cardiac changes. Therapies should be explored to target these preclinical cardiac changes to modify cardiovascular risk associated with Type 2 diabetes and NAFLD.


Publication metadata

Author(s): Cassidy S, Hallsworth K, Thoma C, MacGowan GA, Hollingsworth KG, Day CP, Taylor R, Jakovljevic DG, Trenell MI

Publication type: Article

Publication status: Published

Journal: Cardiovascular Diabetology

Year: 2015

Volume: 14

Online publication date: 13/02/2015

Acceptance date: 28/01/2015

ISSN (electronic): 1475-2840

Publisher: BioMed Central Ltd.

URL: http://dx.doi.org/10.1186/s12933-015-0187-2

DOI: 10.1186/s12933-015-0187-2


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