Document Detail


Hyperamylinemia contributes to cardiac dysfunction in obesity and diabetes: a study in humans and rats.
MedLine Citation:
PMID:  22275486     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
RATIONALE: Hyperamylinemia is common in patients with obesity and insulin resistance, coincides with hyperinsulinemia, and results in amyloid deposition. Amylin amyloids are generally considered a pancreatic disorder in type 2 diabetes. However, elevated circulating levels of amylin may also lead to amylin accumulation and proteotoxicity in peripheral organs, including the heart.
OBJECTIVE: To test whether amylin accumulates in the heart of obese and type 2 diabetic patients and to uncover the effects of amylin accumulation on cardiac morphology and function.
METHODS AND RESULTS: We compared amylin deposition in failing and nonfailing hearts from lean, obese, and type 2 diabetic humans using immunohistochemistry and Western blots. We found significant accumulation of large amylin oligomers, fibrils, and plaques in failing hearts from obese and diabetic patients but not in normal hearts and failing hearts from lean, nondiabetic humans. Small amylin oligomers were even elevated in nonfailing hearts from overweight/obese patients, suggesting an early state of accumulation. Using a rat model of hyperamylinemia transgenic for human amylin, we observed that amylin oligomers attach to the sarcolemma, leading to myocyte Ca(2+) dysregulation, pathological myocyte remodeling, and diastolic dysfunction, starting from prediabetes. In contrast, prediabetic rats expressing the same level of wild-type rat amylin, a nonamyloidogenic isoform, exhibited normal heart structure and function.
CONCLUSIONS: Hyperamylinemia promotes amylin deposition in the heart, causing alterations of cardiac myocyte structure and function. We propose that detection and disruption of cardiac amylin buildup may be both a predictor of heart dysfunction and a novel therapeutic strategy in diabetic cardiomyopathy.
Authors:
Sanda Despa; Kenneth B Margulies; Le Chen; Anne A Knowlton; Peter J Havel; Heinrich Taegtmeyer; Donald M Bers; Florin Despa
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.     Date:  2012-01-24
Journal Detail:
Title:  Circulation research     Volume:  110     ISSN:  1524-4571     ISO Abbreviation:  Circ. Res.     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-02-20     Completed Date:  2012-04-09     Revised Date:  2012-05-24    
Medline Journal Info:
Nlm Unique ID:  0047103     Medline TA:  Circ Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  598-608     Citation Subset:  IM    
Affiliation:
Department of Pharmacology, University of California-Davis, 451 Health Sciences Drive, Davis, CA 95616, USA. fdespa@ucdavis.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Animals
Blotting, Western
Calcium Signaling
Cardiomegaly / etiology,  metabolism,  physiopathology
Diabetes Mellitus, Type 2 / complications*,  metabolism
Diabetic Cardiomyopathies / etiology*,  metabolism,  physiopathology,  ultrasonography
Disease Models, Animal
Female
Heart Failure / etiology*,  metabolism,  physiopathology,  ultrasonography
Histone Deacetylases / metabolism
Humans
Immunohistochemistry
Islet Amyloid Polypeptide / genetics,  metabolism*
Male
Middle Aged
Myocardium / metabolism*,  pathology
NFATC Transcription Factors / metabolism
Obesity / complications*,  metabolism
Prediabetic State / complications*,  metabolism
Rats
Rats, Sprague-Dawley
Rats, Transgenic
Ventricular Dysfunction, Left / etiology,  metabolism,  physiopathology
Ventricular Function, Left
Ventricular Pressure
Ventricular Remodeling
Young Adult
Grant Support
ID/Acronym/Agency:
AT003645/AT/NCCAM NIH HHS; DK087307/DK/NIDDK NIH HHS; HL075675/HL/NHLBI NIH HHS; HL091333/HL/NHLBI NIH HHS; HL107256/HL/NHLBI NIH HHS; P01 HL080101-05/HL/NHLBI NIH HHS; R01 HL061483-10/HL/NHLBI NIH HHS; R01 HL109501-01/HL/NHLBI NIH HHS; R01 HL109501-02/HL/NHLBI NIH HHS; R01-AG017022/AG/NIA NIH HHS; R01-HL061483/HL/NHLBI NIH HHS; R01-HL073162/HL/NHLBI NIH HHS; R01-HL077281/HL/NHLBI NIH HHS; R01-HL079071/HL/NHLBI NIH HHS; R01-HL089847/HL/NHLBI NIH HHS; R01-HL109501/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Islet Amyloid Polypeptide; 0/NFATC Transcription Factors; EC 3.5.1.98/Histone Deacetylases

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