Metabolic Syndrome Is Associated With Impaired Insulin-Stimulated Myocardial Glucose Metabolic Rate in Individuals With Type 2 Diabetes: A Cardiac Dynamic 18F-FDG-PET Study

Elena Succurro; Patrizia Vizza; Annalisa Papa; Francesco Cicone; Giuseppe Monea; Giuseppe Tradigo; Teresa Vanessa Fiorentino; Maria Perticone; Pietro Hiram Guzzi; Angela Sciacqua; Francesco Andreozzi; Pierangelo Veltri; Giuseppe Lucio Cascini; Giorgio Sesti

doi:10.3389/fcvm.2022.924787

Metabolic Syndrome Is Associated With Impaired Insulin-Stimulated Myocardial Glucose Metabolic Rate in Individuals With Type 2 Diabetes: A Cardiac Dynamic ¹⁸F-FDG-PET Study

Front Cardiovasc Med. 2022 Jun 29:9:924787. doi: 10.3389/fcvm.2022.924787. eCollection 2022.

Authors

Elena Succurro^{1

2}, Patrizia Vizza¹, Annalisa Papa³, Francesco Cicone³, Giuseppe Monea¹, Giuseppe Tradigo⁴, Teresa Vanessa Fiorentino¹, Maria Perticone¹, Pietro Hiram Guzzi¹, Angela Sciacqua^{1

2}, Francesco Andreozzi^{1

2}, Pierangelo Veltri¹, Giuseppe Lucio Cascini³, Giorgio Sesti⁵

Affiliations

¹ Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy.
² Research Center for the Prevention and Treatment of Metabolic Diseases (CR METDIS), University Magna Graecia of Catanzaro, Catanzaro, Italy.
³ Department of Experimental and Clinical Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy.
⁴ Ecampus University, Novedrate, Italy.
⁵ Department of Clinical and Molecular Medicine, University of Rome-Sapienza, Rome, Italy.

Abstract

Metabolic syndrome is a condition characterized by a clustering of metabolic abnormalities associated with an increased risk of type 2 diabetes and cardiovascular disease. An impaired insulin-stimulated myocardial glucose metabolism has been shown to be a risk factor for the development of cardiovascular disease in patients with type 2 diabetes. Whether cardiac insulin resistance occurs in subjects with metabolic syndrome remains uncertain. To investigate this issue, we evaluated myocardial glucose metabolic rate using cardiac dynamic ¹⁸F-FDG-PET combined with euglycemic-hyperinsulinemic clamp in three groups: a group of normal glucose tolerant individuals without metabolic syndrome (n = 10), a group of individuals with type 2 diabetes and metabolic syndrome (n = 19), and a group of subjects with type 2 diabetes without metabolic syndrome (n = 6). After adjusting for age and gender, individuals with type 2 diabetes and metabolic syndrome exhibited a significant reduction in insulin-stimulated myocardial glucose metabolic rate (10.5 ± 9.04 μmol/min/100 g) as compared with both control subjects (32.9 ± 9.7 μmol/min/100 g; P < 0.0001) and subjects with type 2 diabetes without metabolic syndrome (25.15 ± 4.92 μmol/min/100 g; P = 0.01). Conversely, as compared with control subjects (13.01 ± 8.53 mg/min x Kg FFM), both diabetic individuals with metabolic syndrome (3.06 ± 1.7 mg/min × Kg FFM, P = 0.008) and those without metabolic syndrome (2.91 ± 1.54 mg/min × Kg FFM, P = 0.01) exhibited a significant reduction in whole-body insulin-stimulated glucose disposal, while no difference was observed between the 2 groups of subjects with type 2 diabetes with or without metabolic syndrome. Univariate correlations showed that myocardial glucose metabolism was positively correlated with insulin-stimulated glucose disposal (r = 0.488, P = 0.003), and negatively correlated with the presence of metabolic syndrome (r = -0.743, P < 0.0001) and with its individual components. In conclusion, our data suggest that an impaired myocardial glucose metabolism may represent an early cardio-metabolic defect in individuals with the coexistence of type 2 diabetes and metabolic syndrome, regardless of whole-body insulin resistance.

Keywords: cardiac 18F-FDG-PET; cardiovascular disease; insulin resistance; metabolic syndrome; myocardial glucose metabolism; type 2 diabetes.