Cardiac lipid content is unresponsive to a physical activity training intervention in type 2 diabetic patients, despite improved ejection fractionReport as inadecuate




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Cardiovascular Diabetology

, 10:47

First Online: 26 May 2011Received: 14 March 2011Accepted: 26 May 2011

Abstract

BackgroundIncreased cardiac lipid content has been associated with diabetic cardiomyopathy. We recently showed that cardiac lipid content is reduced after 12 weeks of physical activity training in healthy overweight subjects. The beneficial effect of exercise training on cardiovascular risk is well established and the decrease in cardiac lipid content with exercise training in healthy overweight subjects was accompanied by improved ejection fraction. It is yet unclear whether diabetic patients respond similarly to physical activity training and whether a lowered lipid content in the heart is necessary for improvements in cardiac function. Here, we investigated whether exercise training is able to lower cardiac lipid content and improve cardiac function in type 2 diabetic patients.

MethodsEleven overweight-to-obese male patients with type 2 diabetes mellitus age: 58.4 ± 0.9 years, BMI: 29.9 ± 0.01 kg-m followed a 12-week training program combination endurance-strength training, three sessions-week. Before and after training, maximal whole body oxygen uptake VO2max and insulin sensitivity by hyperinsulinemic, euglycemic clamp was determined. Systolic function was determined under resting conditions by CINE-MRI and cardiac lipid content in the septum of the heart by Proton Magnetic Resonance Spectroscopy.

ResultsVO2max increased from 27.1 ± 1.5 to 30.1 ± 1.6 ml-min-kg, p = 0.001 and insulin sensitivity improved upon training insulin stimulated glucose disposal delta Rd of glucose improved from 5.8 ± 1.9 to 10.3 ± 2.0 μmol-kg-min, p = 0.02. Left-ventricular ejection fraction improved after training from 50.5 ± 2.0 to 55.6 ± 1.5%, p = 0.01 as well as cardiac index and cardiac output. Unexpectedly, cardiac lipid content in the septum remained unchanged from 0.80 ± 0.22% to 0.95 ± 0.21%, p = 0.15.

ConclusionsTwelve weeks of progressive endurance-strength training was effective in improving VO2max, insulin sensitivity and cardiac function in patients with type 2 diabetes mellitus. However, cardiac lipid content remained unchanged. These data suggest that a decrease in cardiac lipid content in type 2 diabetic patients is not a prerequisite for improvements in cardiac function.

Trial registrationISRCTN: ISRCTN43780395

Keywordsmagnetic resonance spectroscopy magnetic resonance imaging ectopic fat type 2 diabetes mellitus exercise cardiomyopathy lipotoxicity Electronic supplementary materialThe online version of this article doi:10.1186-1475-2840-10-47 contains supplementary material, which is available to authorized users.

Patrick Schrauwen and M Eline Kooi contributed equally to this work.

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Author: Vera B Schrauwen-Hinderling - Ruth CR Meex - Matthijs KC Hesselink - Tineke van de Weijer - Tim Leiner - Michael Schär -

Source: https://link.springer.com/article/10.1186/1475-2840-10-47







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