Effect of Obesity and Insulin Resistance on Myocardial Substrate Metabolism and Efficiency in Young Women

Linda R. Peterson, Pilar Herrero, Kenneth B. Schechtman, Susan B. Racette, Alan D. Waggoner, Zulia Kisrieva-Ware, Carmen Dence, Samuel Klein, Jo Ann Marsala, Timothy Meyer, Robert J. Gropler

Research output: Contribution to journalArticle

418 Scopus citations

Abstract

Background-Obesity is a risk factor for impaired cardiac performance, particularly in women. Animal studies suggest that alterations in myocardial fatty acid metabolism and efficiency in obesity can cause decreased cardiac performance. In the present study, we tested the hypothesis that myocardial fatty acid metabolism and efficiency are abnormal in obese women. Methods and Results-We studied 31 young women (body mass index [BMI] 19 to 52 kg/m 2); 19 were obese (BMI >30 kg/m2). Myocardial oxygen consumption (MV̇o2) and fatty acid uptake (MFAUp), utilization (MFAU), and oxidation (MFAO) were quantified by positron emission tomography. Cardiac work was measured by echocardiography, and efficiency was calculated as work/MV̇o2. BMI correlated with MV̇o2 (r=0.58, P=0.0006), MFAUp (r=0.42, P<0.05), and efficiency (r= -0.40, P < 0.05). Insulin resistance, quantified by the glucose area under the curve (AUC) during an oral glucose tolerance test, correlated with MFAUp (r=0.55, P<0.005), MFAU (r=0.62, P<0.001), and MFAO (r=0.58, P<0.005). A multivariate, stepwise regression analysis showed that BMI was the only independent predictor of MV̇o2 and efficiency (P=0.0005 and P<0.05, respectively). Glucose AUC was the only independent predictor of MFAUp, MFAU, and MFAO (P<0.05, <0.005, and <0.005, respectively). Conclusions-In young women, obesity is a significant predictor of increased MV̇o2 and decreased efficiency, and insulin resistance is a robust predictor of MFAUp, MFAU, and MFAO. This increase in fatty acid metabolism and decrease in efficiency is concordant with observations made in experimental models of obesity. These metabolic changes may play a role in the pathogenesis of decreased cardiac performance in obese women.

Original languageEnglish
Pages (from-to)2191-2196
Number of pages6
JournalCirculation
Volume109
Issue number18
DOIs
StatePublished - May 11 2004

Keywords

  • Insulin
  • Metabolism
  • Obesity

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