Identification of myocardial insulin resistance by using liver tests: a simple approach for clinical practice
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- dc.contributor.author Herance Camacho, José Raul
- dc.contributor.author Martín-Saladich, Queralt
- dc.contributor.author Velásquez, Mayra Alejandra
- dc.contributor.author Hernandez, Cristina
- dc.contributor.author Aparicio, Carolina
- dc.contributor.author Ramirez-Serra, Clara
- dc.contributor.author Ferrer, Roser
- dc.contributor.author Giralt-Arnaiz, Marina
- dc.contributor.author González Ballester, Miguel Ángel, 1973-
- dc.contributor.author Pericàs, Juan M.
- dc.contributor.author Castell-Conesa, Joan
- dc.contributor.author Aguadé-Bruix, Santiago
- dc.contributor.author Simó, Rafael
- dc.date.accessioned 2023-03-06T07:33:35Z
- dc.date.available 2023-03-06T07:33:35Z
- dc.date.issued 2022
- dc.description.abstract Background: We report that myocardial insulin resistance (mIR) occurs in around 60% of patients with type 2 diabetes (T2D) and was associated with higher cardiovascular risk in comparison with patients with insulin-sensitive myocardium (mIS). These two phenotypes (mIR vs. mIS) can only be assessed using time-consuming and expensive methods. The aim of the present study is to search a simple and reliable surrogate to identify both phenotypes. Methods: Forty-seven patients with T2D underwent myocardial [18F]FDG PET/CT at baseline and after a hyperinsulinemic–euglycemic clamp (HEC) to determine mIR were prospectively recruited. Biochemical assessments were performed before and after the HEC. Baseline hepatic steatosis index and index of hepatic fibrosis (FIB-4) were calculated. Furthermore, liver stiffness measurement was performed using transient elastography. Results: The best model to predict the presence of mIR was the combination of transaminases, protein levels, FIB-4 score and HOMA (AUC = 0.95; sensibility: 0.81; specificity: 0.95). We observed significantly higher levels of fibrosis in patients with mIR than in those with mIS (p = 0.034). In addition, we found that patients with mIR presented a reduced glucose uptake by the liver in comparison with patients with mIS. Conclusions: The combination of HOMA, protein, transaminases and FIB-4 is a simple and reliable tool for identifying mIR in patients with T2D. This information will be useful to improve the stratification of cardiovascular risk in T2D.
- dc.format.mimetype application/pdf
- dc.identifier.citation Herance JR, Martín-Saladich Q, Velásquez MA, Hernandez C, Aparicio C, Ramirez-Serra C, Ferrer R, Giralt-Arnaiz M, González-Ballester MA, Pericàs JM, Castell-Conesa J, Aguadé-Bruix S, Simó R. Identification of myocardial insulin resistance by using liver tests: a simple approach for clinical practice. Int J Mol Sci. 2022;23(15):8783. DOI: 10.3390/ijms23158783
- dc.identifier.doi http://dx.doi.org/10.3390/ijms23158783
- dc.identifier.issn 1661-6596
- dc.identifier.uri http://hdl.handle.net/10230/56056
- dc.language.iso eng
- dc.publisher MDPI
- dc.relation.ispartof International Journal of Molecular Sciences. 2022;23(15):8783.
- dc.rights © 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
- dc.rights.accessRights info:eu-repo/semantics/openAccess
- dc.rights.uri http://creativecommons.org/licenses/by/4.0/
- dc.subject.keyword type 2 diabetes
- dc.subject.keyword myocardial insulin resistance
- dc.subject.keyword non-alcoholic fatty liver disease
- dc.subject.keyword cardiovascular risk
- dc.title Identification of myocardial insulin resistance by using liver tests: a simple approach for clinical practice
- dc.type info:eu-repo/semantics/article
- dc.type.version info:eu-repo/semantics/publishedVersion