Herance Camacho, José RaulMartín-Saladich, QueraltVelásquez, Mayra AlejandraHernandez, CristinaAparicio, CarolinaRamirez-Serra, ClaraFerrer, RoserGiralt-Arnaiz, MarinaGonzález Ballester, Miguel Ángel, 1973-Pericàs, Juan M.Castell-Conesa, JoanAguadé-Bruix, SantiagoSimó, Rafael2023-03-062023-03-062022Herance 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/ijms231587831661-6596http://hdl.handle.net/10230/56056Background: 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.application/pdfeng© 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/).info:eu-repo/semantics/articlehttp://dx.doi.org/10.3390/ijms23158783type 2 diabetesmyocardial insulin resistancenon-alcoholic fatty liver diseasecardiovascular riskinfo:eu-repo/semantics/openAccess