Coronary microvascular function and visceral adiposity in patients with normal body weight and type 2 diabetes
Nome da publicação: Coronary microvascular function and visceral adiposity in patients with normal body weight and type 2 diabetes
Authors: Amrit Chowdhary, Sharmaine Thirunavukarasu, Nicholas Jex, Lauren Coles, Charles Bowers, Anshuman Sengupta, Peter Swoboda, Klaus Witte, Richard Cubbon, Hui Xue, Peter Kellman, John Greenwood, Sven Plein, Eylem Levelt
Source: Obesity
Published in: 2022
File type: Artigo de periódico
Link to the originalSummary
Objective This study sought to assess whether diabetes affects coronary microvascular function in individuals with normal body weight. Methods Seventy-five participants (30 patients with type 2 diabetes [T2D] who were overweight [O-T2D], 15 patients with T2D who were lean [LnT2D], 15 healthy volunteers who were lean [LnHV], and 15 healthy volunteers who were overweight [O-HV]) without established cardiovascular disease were recruited. Participants underwent magnetic resonance imaging for assessment of subcutaneous, epicardial, and visceral adipose tissue areas, adenosine stress myocardial blood flow (MBF), and cardiac structure and function. Results Stress MBF was reduced only in the O-T2D group (mean [SD], LnHV = 2.07 [0.47] mL/g/min, O-HV = 2.08 [0.42] mL/g/min, LnT2D = 2.16 [0.36] mL/g/min, O-T2D = 1.60 [0.28] mL/g/min; p ≤ 0.0001). Accumulation of visceral fat was evident in the LnT2D group at similar levels to the O-HV group (LnHV = 127 [53] cm2, O-HV = 181 [60] cm2, LnT2D = 182 [99] cm2, O-T2D = 288 [72] cm2; p < 0.0001). Only the O-T2D group showed reductions in left ventricular ejection fraction (LnHV = 63% [4%], O-HV = 63% [4%], LnT2D = 60% [5%], O-T2D = 58% [6%]; p = 0.0008) and global longitudinal strain (LnHV = −15.1% [3.1%], O-HV= −15.2% [3.7%], LnT2D = −13.4% [2.7%], O-T2D = −11.1% [2.8%]; p = 0.002) compared with both control groups. Conclusions Patients with T2D and normal body weight do not show alterations in global stress MBF, but they do show significant increases in visceral adiposity. Patients with T2D who were overweight and had no prior cardiovascular disease showed an increase in visceral adiposity and significant reductions in stress MBF.
Summary translated by 
Objetivo Este estudo procurou avaliar se o diabetes afeta a função microvascular coronariana em indivíduos com peso corporal normal. Métodos Setenta e cinco participantes (30 pacientes com diabetes tipo 2 [DT2] que estavam acima do peso [O-T2D], 15 pacientes com DM2 que eram magros [LnT2D], 15 voluntários saudáveis que eram magros [LnHV] e 15 voluntários saudáveis que estavam acima do peso [O-HV]) sem doença cardiovascular estabelecida foram recrutados. Os participantes foram submetidos a ressonância magnética para avaliação das áreas de tecido adiposo subcutâneo, epicárdico e visceral, fluxo sanguíneo miocárdico sob estresse de adenosina (MBF) e estrutura e função cardíaca. Resultados O MBF de estresse foi reduzido apenas no grupo O-T2D (média [DP], LnHV = 2,07 [0,47] mL/g/min, O-HV = 2,08 [0,42] mL/g/min, LnT2D = 2,16 [0,36] mL/g/min, O-T2D = 1,60 [0,28] mL/g/min; p ≤ 0,0001). O acúmulo de gordura visceral foi evidente no grupo LnT2D em níveis semelhantes aos do grupo O-HV (LnHV = 127 [53] cm2, O-HV = 181 [60] cm2, LnT2D = 182 [99] cm2, O-T2D = 288 [72] cm2; p < 0,0001). Apenas o grupo O-T2D apresentou reduções na fração de ejeção do ventrículo esquerdo (LnHV = 63% [4%], O-HV = 63% [4%], LnT2D = 60% [5%], O-T2D = 58% [ 6%]; p = 0,0008) e deformação longitudinal global (LnHV = −15,1% [3,1%], O-HV= −15,2% [3,7%], LnT2D = −13,4% [2,7%], O-T2D = − 11,1% [2,8%]; p = 0,002) em comparação com ambos os grupos de controle. Conclusões Pacientes com DM2 e peso corporal normal não apresentam alterações no estresse global do FSM, mas apresentam aumentos significativos na adiposidade visceral. Pacientes com DM2 com sobrepeso e sem doença cardiovascular prévia apresentaram aumento na adiposidade visceral e reduções significativas no MBF de estresse.