TY - JOUR
T1 - Cardiac lipid content is unresponsive to a physical activity training intervention in type 2 diabetic patients, despite improved ejection fraction
AU - Schrauwen-Hinderling, Vera B.
AU - Meex, Ruth C.R.
AU - Hesselink, Matthijs K.C.
AU - van de Weijer, Tineke
AU - Leiner, Tim
AU - Schär, Michael
AU - Lamb, Hildo J.
AU - Wildberger, Joachim E.
AU - Glatz, Jan F.C.
AU - Schrauwen, Patrick
AU - Kooi, M. Eline
N1 - Funding Information:
This study has been supported by the European Foundation for the Study of Diabetes (EFSD), Düsseldorf, Germany. Dr. P.Schrauwen is supported by a ‘VICI’ Research Grant for innovative research from the Netherlands Organization for Scientific Research, The Hague, The Netherlands (Grant 918.96.618). Dr. M. Hesselink and Ruth Meex are supported by a ‘VIDI’ Research Grant for innovative research from the Netherlands Organization for Scientific Research, The Hague, The Netherlands (Grant 917.66.359). T. van de Weijer was supported by the Center for Translational Molecular Medicine (CTMM), project PREDICCt (grant 01C-104).
PY - 2011/5/26
Y1 - 2011/5/26
N2 - Increased 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.Methods: Eleven overweight-to-obese male patients with type 2 diabetes mellitus (age: 58.4 ± 0.9 years, BMI: 29.9 ± 0.01 kg/m2) 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.Results: VO2max 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).Conclusions: Twelve 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 registration: ISRCTN: ISRCTN43780395.
AB - Increased 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.Methods: Eleven overweight-to-obese male patients with type 2 diabetes mellitus (age: 58.4 ± 0.9 years, BMI: 29.9 ± 0.01 kg/m2) 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.Results: VO2max 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).Conclusions: Twelve 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 registration: ISRCTN: ISRCTN43780395.
KW - Cardiomyopathy
KW - Ectopic fattype 2 diabetes mellitus
KW - Exercise
KW - Lipotoxicity
KW - Magnetic resonance imaging
KW - Magnetic resonance spectroscopy
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U2 - 10.1186/1475-2840-10-47
DO - 10.1186/1475-2840-10-47
M3 - Article
C2 - 21615922
AN - SCOPUS:79957453372
SN - 1475-2840
VL - 10
JO - Cardiovascular Diabetology
JF - Cardiovascular Diabetology
M1 - 47
ER -