Activin a is associated with impaired myocardial glucose metabolism and left ventricular remodeling in patients with uncomplicated type 2 diabetes

作者：Chen Weena J Y; Greulich Sabrina; van der Meer Rutger W; Rijzewijk Luuk J; Lamb Hildo J; de Roos Albert; Smit Johannes W A; Romijn Johannes A; Ruige Johannes B; Lammertsma Adriaan A; Lubberink Mark; Diamant Michaela; Ouwens D Margriet^*

来源：Cardiovascular Diabetology, 2013, 12(1): 150.

DOI：10.1186/1475-2840-12-150

• Activin A
• Myocardial glucose metabolism
• Cardiac remodeling
• Diabetic cardiomyopathy

Background: Activin A released from epicardial adipose tissue has been linked to contractile dysfunction and insulin resistance in cardiomyocytes. This study investigated the role of activin A in clinical diabetic cardiomyopathy by assessing whether circulating activin A levels associate with cardiometabolic parameters in men with uncomplicated type 2 diabetes (T2D), and the effects of treatment with pioglitazone versus metformin on these associations. %26lt;br%26gt;Methods: Seventy-eight men with uncomplicated T2D and fourteen healthy men with comparable age were included, in this randomized, double-blind, active comparator intervention study. All T2D men were on glimipiride monotherapy, and randomized to a 24-week intervention with either pioglitazone or metformin. Cardiac dimensions and function were measured using magnetic resonance imaging, whilst myocardial glucose metabolism (MMRglu) was determined using [F-18]-2-fluoro-2-deoxy-D-glucose positron emission tomography during a hyperinsulinemic-euglycemic clamp. %26lt;br%26gt;Results: Circulating activin A levels were comparable in T2D men and controls. Activin A levels were independently inversely associated with MMRglu, and positively with left ventricular mass/volume (LVMV)-ratio in T2D men. Intervention with metformin decreased activin A levels, whereas pioglitazone did not alter activin A levels. The changes in plasma activin A levels were not correlated with the changes in MMRglu following either pioglitazone or metformin treatment. A borderline significant correlation (p = 0.051) of changes in plasma activin A levels and changes in LVMV-ratio was observed after pioglitazone treatment. %26lt;br%26gt;Conclusions: Circulating activin A levels are associated with impaired myocardial glucose metabolism and high LVMV-ratio in patients with uncomplicated T2D, reflecting a potential detrimental role in early human diabetic cardiomyopathy.

• 出版日期2013-10-17