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Insulin resistance in patients with cardiac hypertrophy

G Paternostro1, D Pagano, T Gnecchi-Ruscone

  • 1MRC Cyclotron Unit, Imperial College School of Medicine, Hammersmith Hospital, London, UK.

Cardiovascular Research
|August 6, 1999
PubMed

Insights

Human cardiac hypertrophy is linked to insulin resistance, even without diabetes or heart disease. This may be due to changes in glucose transporters like GLUT-4 and GLUT-1.

Area of Science:

  • Cardiology
  • Metabolic Research
  • Molecular Biology

Background:

  • Animal studies suggest a link between left ventricular hypertrophy, insulin resistance, and glucose transporter alterations.
  • Previous research demonstrated myocardial insulin resistance in patients with post-ischemic heart failure.

Purpose of the Study:

  • To investigate myocardial insulin resistance in human cardiac hypertrophy.
  • To determine if insulin resistance occurs in the absence of hypertension, diabetes, and coronary artery disease.

Main Methods:

  • Compared 11 patients with cardiac hypertrophy (aortic stenosis) to 11 healthy volunteers.
  • Measured myocardial glucose uptake (MGU) using positron emission tomography and [18F]2-fluoro-2-deoxy-D-glucose under fasting and hyperinsulinemic clamp conditions.
  • Analyzed myocardial biopsies for insulin-independent (GLUT-1) and insulin-dependent (GLUT-4) glucose transporter expression.

Main Results:

  • MGU was comparable during fasting but markedly reduced in patients during the clamp study (p < 0.01).
  • Patients exhibited a decreased GLUT-4/GLUT-1 ratio compared to controls.
  • Similar plasma insulin levels were observed between groups during the clamp.

Conclusions:

  • Insulin resistance is a characteristic of the hypertrophied heart, independent of hypertension, coronary artery disease, and diabetes.
  • Abnormalities in glucose transporters, specifically the GLUT-4/GLUT-1 ratio, likely contribute to myocardial insulin resistance in cardiac hypertrophy.
Abstract

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