Noninvasive imaging biomarkers like 18F-FDG PET can detect early metabolic perturbations in myocardial glucose utility prior to the decline of left ventricular function in a high-fat diet-induced insulin resistance model.
Early PET/NMR detects myocardial glucose shifts before LV decline in HFD rats; leaves open translation to human insulin-resistance screening.
Background . High-fat diet (HFD) induces systemic insulin resistance leading to myocardial dysfunction. We aim to characterize the early adaptations of myocardial glucose utility to HFD-induced insulin resistance. Methods . Male Sprague–Dawley rats were assigned into two groups, fed a regular chow diet or HFD ad libitum for 10 weeks. We used in vivo imaging of cardiac magnetic resonance (CMR), 18 F-FDG PET, and ex vivo nuclear magnetic resonance (NMR) metabolomic analysis for the carbon-13-labeled glucose ([U- 13 C]Glc) perfused myocardium. Results . As compared with controls, HFD rats had a higher ejection fraction and a smaller left ventricular end-systolic volume (P<0.05), with SUV max of myocardium on 18 F-FDG PET significantly increased in 4 weeks (P<0.005). The [U- 13 C]Glc probed the increased glucose uptake being metabolized into pyruvate and acetyl-CoA, undergoing oxidative phosphorylation via the tricarboxylic acid (TCA) cycle, and then synthesized into glutamic acid and glutamine, associated with overexpressed LC3B (P<0.05). Conclusions . HFD-induced IR associated with increased glucose utility undergoing oxidative phosphorylation via the TCA cycle in the myocardium is supported by overexpression of glucose transporter, acetyl-CoA synthase. Noninvasive imaging biomarker has potentials in detecting the metabolic perturbations prior to the decline of the left ventricular function.
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Chung et al. (2018) studied this question.
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