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Imaging of Organ Metabolism in Obesity and Diabetes: Treatment Perspectives
J C Hannukainen, M A Guzzardi, K A Virtanen
1Institute of Clinical Physiology, National Research Council (CNR), Via Moruzzi 1, 56124, Pisa, Italy. patricia.iozzo@ifc.cnr.it.
Abstract:
Obesity and diabetes are growing threats for cardiovascular diseases (CVD) and heart failure. In order to identify early and effective treatment or prevention targets, it is fundamental to dissect the role of each organ and the sequence of events leading from health to obesity, diabetes and cardiovascular diseases. The advancements in imaging modalities to evaluate organ-specific metabolism in humans in vivo is substantially contributing to the stratification of risk, identification of organ-specific culprits and development of targeted treatment strategies. This review summarizes the contribution provided by imaging of the heart, skeletal muscle, adipose tissue, liver, pancreas, gut and brain to the understanding of the pathogenesis and cardio-metabolic complications of obesity and diabetes, and to the monitoring of treatment responses in humans. We conclude by suggesting emerging fields of investigation, including the role of cardiac fat in the pathogenesis of cardiovascular disease, the conversion of white into brown adipose tissue in the treatment of obesity, the control of weight and energy balance by the brain, the integration between omics and imaging technologies to help establish biomarkers, and the characterization of gut metabolism in relation with the gut microbiome, opening a very promising preventive/therapeutic perspective.
Insights
Imaging organ metabolism helps understand obesity and diabetes complications. This approach aids in identifying therapeutic targets for cardiovascular diseases and heart failure, improving patient outcomes.
Area of Science:
- Cardiovascular Medicine
- Metabolic Disorders
- Medical Imaging
Background:
- Obesity and diabetes are significant risk factors for cardiovascular diseases (CVD) and heart failure.
- Understanding the sequence of events from health to these conditions is crucial for effective prevention and treatment.
Purpose of the Study:
- To review the role of in vivo organ-specific metabolic imaging in understanding the pathogenesis of obesity and diabetes.
- To highlight how imaging aids in identifying culprits and monitoring treatment responses for cardio-metabolic complications.
Main Methods:
- Review of advancements in imaging modalities for evaluating organ-specific metabolism in humans.
- Synthesis of findings from imaging studies on the heart, skeletal muscle, adipose tissue, liver, pancreas, gut, and brain.
Main Results:
- Imaging advances risk stratification and identifies organ-specific factors in obesity and diabetes.
- Organ-specific metabolic imaging provides insights into pathogenesis and treatment monitoring for CVD.
Conclusions:
- Imaging of multiple organs is vital for understanding cardio-metabolic diseases.
- Emerging areas include cardiac fat, brown adipose tissue conversion, brain's role in energy balance, omics-imaging integration, and gut microbiome metabolism.
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