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首页> 外文期刊>American Journal of Physiology >Liver steatosis coexists with myocardial insulin resistance and coronary dysfunction in patients with type 2 diabetes.
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Liver steatosis coexists with myocardial insulin resistance and coronary dysfunction in patients with type 2 diabetes.

机译：2型糖尿病患者的肝脏脂肪变性与心肌胰岛素抵抗和冠状动脉功能障碍并存。

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Nonalcoholic fatty liver (NAFL) is a common comorbidity in patients with type 2 diabetes and links to the risk of coronary syndromes. The aim was to determine the manifestations of metabolic syndrome in different organs in patients with liver steatosis. We studied 55 type 2 diabetic patients with coronary artery disease using positron emission tomography. Myocardial perfusion was measured with [15O]H2O and myocardial and skeletal muscle glucose uptake with 2-deoxy-2-[18F]fluoro-D-glucose during hyperinsulinemic euglycemia. Liver fat content was determined by magnetic resonance proton spectroscopy. Patients were divided on the basis of their median (8%) into two groups with low (4.6 +/- 2.0%) and high (17.4 +/- 8.0%) liver fat content. The groups were well matched for age, BMI, and fasting plasma glucose. In addition to insulin resistance at the whole body level (P = 0.012) and muscle (P = 0.002), the high liver fat group had lower insulin-stimulated myocardial glucose uptake (P = 0.040) and glucose extraction rate (P = 0.0006) compared with the low liver fat group. In multiple regression analysis, liver fat content was the most significant explanatory variable for myocardial insulin resistance. In addition, the high liver fat group had increased concentrations of high sensitivity C-reactive protein, soluble forms of E-selectin, vascular adhesion protein-1, and intercellular adhesion molecule-1 (P < 0.05) and lower coronary flow reserve (P = 0.02) compared with the low liver fat group. In conclusion, in patients with type 2 diabetes and coronary artery disease, liver fat content is a novel independent indicator of myocardial insulin resistance and reduced coronary functional capacity. Further studies will reveal the effect of hepatic fat reduction on myocardial metabolism and coronary function.
机译：非酒精性脂肪肝（NAFL）是2型糖尿病患者的常见合并症，与冠状动脉综合征的风险有关。目的是确定肝脂肪变性患者不同器官代谢综合征的表现。我们使用正电子发射断层扫描技术研究了55名2型糖尿病冠心病患者。在高胰岛素正常血糖期间，用[15O] H2O测量心肌灌注，并用2-脱氧-2- [18F]氟-D-葡萄糖测量心肌和骨骼肌的葡萄糖摄取。肝脂肪含量通过磁共振质子光谱法测定。根据中位数（8％）将患者分为肝脂肪含量低（4.6 +/- 2.0％）和高（17.4 +/- 8.0％）的两组。各组的年龄，BMI和空腹血糖均匹配良好。除了在全身水平（P = 0.012）和肌肉（P = 0.002）的胰岛素抵抗外，高肝脂肪组的胰岛素刺激的心肌葡萄糖摄取（P = 0.040）和葡萄糖提取率（P = 0.0006）也较低。与低肝脂肪组相比。在多元回归分析中，肝脂肪含量是心肌胰岛素抵抗的最重要的解释变量。此外，高肝脂肪组的高敏感性C反应蛋白，E-选择蛋白的可溶性形式，血管黏附蛋白1和细胞间黏附分子1的浓度升高（P <0.05），冠状动脉血流储备降低（P = 0.02）与低肝脂肪组相比。总之，在患有2型糖尿病和冠状动脉疾病的患者中，肝脂肪含量是心肌胰岛素抵抗和冠状动脉功能下降的新型独立指标。进一步的研究将揭示减少肝脏脂肪对心肌代谢和冠状动脉功能的影响。

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