Document Detail

Impact of type 2 diabetes on myocardial insulin sensitivity to glucose uptake and perfusion in patients with coronary artery disease.
MedLine Citation:
PMID:  16984986     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND HYPOTHESIS: Myocardial insulin resistance (IR) is a feature of coronary artery disease (CAD) with reduced left ventricular ejection fraction (LVEF). Whether type 2 diabetes mellitus (T2DM) with CAD and preserved LVEF induces myocardial IR and whether insulin in these patients acts as a myocardial vasodilator is debated. METHODS: We studied 27 CAD patients (LVEF > 50%): 12 with T2DM (CAD+DM), 15 without T2DM (CAD-NoDM). Regional myocardial and skeletal glucose uptake, myocardial and skeletal muscle perfusion were measured with positron emission tomography. Myocardial muscle perfusion was measured at rest and during hyperemia in nonstenotic and stenotic regions with and without acute hyperinsulinemia. RESULTS: Myocardial glucose uptake was similar in CAD+DM and CAD-NoDM in both nonstenotic and stenotic regions [0.38 +/- 0.08 and 0.36 +/- 0.11 micromol/g.min; P value nonsignificant (NS)] and (0.35 +/- 0.09 and 0.37 +/- 0.13 micromol/g.min; P = NS). Skeletal glucose uptake was reduced in CAD+DM (0.05 +/- 0.04 vs. 0.10 +/- 0.05 micromol/g.min; P = 0.02), and likewise, whole-body glucose uptake was reduced in CAD+DM (4.0 +/- 2.8 vs. 7.0 +/- 2.4 mg/kg.min; P = 0.01). Insulin did not alter myocardial muscle perfusion at rest or during hyperemia. Insulin increased skeletal muscle perfusion in CAD-NoDM (0.11 +/- 0.03 vs. 0.06 +/- 0.03 ml/g.min; P = 0.02), but not in CAD+DM (0.08 +/- 0.04 and 0.09 +/- 0.05 ml/g.min; P = NS). CONCLUSION: Myocardial IR to glucose uptake is not an inherent feature in T2DM patients with preserved LVEF. Acute physiological insulin exposure exerts no coronary vasodilation in CAD patients irrespective of T2DM.
Hanne M Søndergaard; Morten Bøttcher; Mette Marie Madsen; Ole Schmitz; Søren B Hansen; Torsten T Nielsen; Hans Erik Bøtker
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2006-09-19
Journal Detail:
Title:  The Journal of clinical endocrinology and metabolism     Volume:  91     ISSN:  0021-972X     ISO Abbreviation:  J. Clin. Endocrinol. Metab.     Publication Date:  2006 Dec 
Date Detail:
Created Date:  2006-12-06     Completed Date:  2007-01-25     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0375362     Medline TA:  J Clin Endocrinol Metab     Country:  United States    
Other Details:
Languages:  eng     Pagination:  4854-61     Citation Subset:  AIM; IM    
Department of Cardiology B, Aarhus University Hospital (SKS), Brendstrupgaardsvej 100, DK-8200 Aarhus N, Denmark.
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MeSH Terms
Blood Glucose / analysis
Blood Pressure
Coronary Artery Disease / complications*,  metabolism*
Diabetes Mellitus, Type 2 / complications*,  metabolism*
Fluorodeoxyglucose F18 / pharmacokinetics
Glucose / metabolism*
Heart Rate
Insulin Resistance*
Middle Aged
Muscle, Skeletal / metabolism
Myocardium / metabolism*
Perfusion / methods
Positron-Emission Tomography
Reg. No./Substance:
0/Blood Glucose; 50-99-7/Glucose; 63503-12-8/Fluorodeoxyglucose F18

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