Obesity dominates early effects on cardiac structure and arterial stiffness in people with type 2 diabetes

Layla A. Abushamat; Daniel Enge; Takashi Fujiwara; Michal Schäfer; Ethan W. Clark; Erin K. Englund; Rebecca L. Scalzo; Aspen Johnston; Deirdre Rafferty; Irene E. Schauer; Mary O. Whipple; Kendall Hunter; Amy G. Huebschmann; Kristen J. Nadeau; Kelly Jarvis; Alex J. Barker; Judith G. Regensteiner; Jane E.B. Reusch

doi:10.1097/HJH.0000000000003534

Obesity dominates early effects on cardiac structure and arterial stiffness in people with type 2 diabetes

Layla A. Abushamat^*, Daniel Enge, Takashi Fujiwara, Michal Schäfer, Ethan W. Clark, Erin K. Englund, Rebecca L. Scalzo, Aspen Johnston, Deirdre Rafferty, Irene E. Schauer, Mary O. Whipple, Kendall Hunter, Amy G. Huebschmann, Kristen J. Nadeau, Kelly Jarvis, Alex J. Barker, Judith G. Regensteiner, Jane E.B. Reusch

^*Corresponding author for this work

Radiology

Research output: Contribution to journal › Article › peer-review

1 Scopus citations

Abstract

Objective:Type 2 diabetes (T2D) and obesity are global epidemics leading to excess cardiovascular disease (CVD). This study investigates standard and novel cardiac MRI parameters to detect subclinical cardiac and central vascular dysfunction in inactive people with and without T2D.Methods:Physically inactive age and BMI-similar premenopausal women and men with (n = 22) and without [n = 34, controls with overweight/obesity (CWO)] uncomplicated T2D were compared to an age-similar and sex-similar reference control cohort (n = 20). Left ventricular (LV) structure, function, and aortic stiffness were assessed by MRI. Global arterial pulse wave velocity (PWV) was assessed using carotid-to-femoral applanation tonometry. Regional PWV was measured via 2D phase-contrast MRI and 4D flow MRI.Results:Global arterial PWV did not differ between CWO and T2D. 2D PC-MRI PWV in the ascending aorta was higher in people with T2D compared with CWOs (P < 0.01). 4D flow PWV in the thoracic aorta was higher in CWO (P < 0.01), and T2D (P < 0.001) compared with RC. End-diastolic volume, end-systolic volume, stroke volume, and cardiac output were lower in CWO and T2D groups compared with reference control.Conclusion:Subclinical changes in arterial stiffening and cardiac remodeling in inactive CWO and T2D compared with reference control support obesity and/or physical inactivity as determinants of incipient CVD complications in uncomplicated T2D. Future studies should determine the mechanistic causes of the CVD complications in greater detail in order to create therapeutic targets.Clinical Trial Registration:Cardiovascular Mechanisms of Exercise Intolerance in Diabetes and the Role of Sex (NCT03419195).

Original language	English (US)
Pages (from-to)	1775-1784
Number of pages	10
Journal	Journal of hypertension
Volume	41
Issue number	11
DOIs	https://doi.org/10.1097/HJH.0000000000003534
State	Published - Nov 1 2023

Funding

Research reported in this publication was supported, in part, by the National Institutes of Health's National Institute on Aging, Grant Number P30AG059988 and K01AG080070. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Other funding includes the VA Clinical Merit CX001532 (J.E.B.R.), VA Merit BX002046, NIH-5T32HL007171, VA CDA2 BX004533 (R.L.S.), NIH-NCATS, UL1TR001082 (J.E.B.R., J.G.R., R.L.S.), Ludeman Family Center for Women's Health Research (R.L.S., J.G.R., J.E.B.R., D.E.), ADA Cardiovascular Metabolism Fellowship Award 1-21-CMF-003 (L.A.). NIH predoctoral support T32DK120520 (D.E.), P30 DK116073 (J.E.B.R.), NIH/NCATS Colorado CTSA Grant Number KL2 TR002534 (E.K.E.), AHA853697 (E.K.E.) and ADA Junior Faculty Award 7-11-JF-42 (I.E.S.).

Keywords

aortic stiffness
cardiac MRI
heart failure
obesity
physical inactivity
pulse wave velocity
type 2 diabetes

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine
Physiology
Internal Medicine

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1097/HJH.0000000000003534

Cite this

Abushamat, L. A., Enge, D., Fujiwara, T., Schäfer, M., Clark, E. W., Englund, E. K., Scalzo, R. L., Johnston, A., Rafferty, D., Schauer, I. E., Whipple, M. O., Hunter, K., Huebschmann, A. G., Nadeau, K. J., Jarvis, K., Barker, A. J., Regensteiner, J. G., & Reusch, J. E. B. (2023). Obesity dominates early effects on cardiac structure and arterial stiffness in people with type 2 diabetes. Journal of hypertension, 41(11), 1775-1784. https://doi.org/10.1097/HJH.0000000000003534

@article{fdec5a1fd0324146bc92f05dff8da2f1,

title = "Obesity dominates early effects on cardiac structure and arterial stiffness in people with type 2 diabetes",

abstract = "Objective:Type 2 diabetes (T2D) and obesity are global epidemics leading to excess cardiovascular disease (CVD). This study investigates standard and novel cardiac MRI parameters to detect subclinical cardiac and central vascular dysfunction in inactive people with and without T2D.Methods:Physically inactive age and BMI-similar premenopausal women and men with (n = 22) and without [n = 34, controls with overweight/obesity (CWO)] uncomplicated T2D were compared to an age-similar and sex-similar reference control cohort (n = 20). Left ventricular (LV) structure, function, and aortic stiffness were assessed by MRI. Global arterial pulse wave velocity (PWV) was assessed using carotid-to-femoral applanation tonometry. Regional PWV was measured via 2D phase-contrast MRI and 4D flow MRI.Results:Global arterial PWV did not differ between CWO and T2D. 2D PC-MRI PWV in the ascending aorta was higher in people with T2D compared with CWOs (P < 0.01). 4D flow PWV in the thoracic aorta was higher in CWO (P < 0.01), and T2D (P < 0.001) compared with RC. End-diastolic volume, end-systolic volume, stroke volume, and cardiac output were lower in CWO and T2D groups compared with reference control.Conclusion:Subclinical changes in arterial stiffening and cardiac remodeling in inactive CWO and T2D compared with reference control support obesity and/or physical inactivity as determinants of incipient CVD complications in uncomplicated T2D. Future studies should determine the mechanistic causes of the CVD complications in greater detail in order to create therapeutic targets.Clinical Trial Registration:Cardiovascular Mechanisms of Exercise Intolerance in Diabetes and the Role of Sex (NCT03419195).",

keywords = "aortic stiffness, cardiac MRI, heart failure, obesity, physical inactivity, pulse wave velocity, type 2 diabetes",

author = "Abushamat, {Layla A.} and Daniel Enge and Takashi Fujiwara and Michal Sch{\"a}fer and Clark, {Ethan W.} and Englund, {Erin K.} and Scalzo, {Rebecca L.} and Aspen Johnston and Deirdre Rafferty and Schauer, {Irene E.} and Whipple, {Mary O.} and Kendall Hunter and Huebschmann, {Amy G.} and Nadeau, {Kristen J.} and Kelly Jarvis and Barker, {Alex J.} and Regensteiner, {Judith G.} and Reusch, {Jane E.B.}",

year = "2023",

month = nov,

day = "1",

doi = "10.1097/HJH.0000000000003534",

language = "English (US)",

volume = "41",

pages = "1775--1784",

journal = "Journal of hypertension",

issn = "0263-6352",

publisher = "Lippincott Williams and Wilkins",

number = "11",

}

Abushamat, LA, Enge, D, Fujiwara, T, Schäfer, M, Clark, EW, Englund, EK, Scalzo, RL, Johnston, A, Rafferty, D, Schauer, IE, Whipple, MO, Hunter, K, Huebschmann, AG, Nadeau, KJ, Jarvis, K, Barker, AJ, Regensteiner, JG & Reusch, JEB 2023, 'Obesity dominates early effects on cardiac structure and arterial stiffness in people with type 2 diabetes', Journal of hypertension, vol. 41, no. 11, pp. 1775-1784. https://doi.org/10.1097/HJH.0000000000003534

TY - JOUR

T1 - Obesity dominates early effects on cardiac structure and arterial stiffness in people with type 2 diabetes

AU - Abushamat, Layla A.

AU - Enge, Daniel

AU - Fujiwara, Takashi

AU - Schäfer, Michal

AU - Clark, Ethan W.

AU - Englund, Erin K.

AU - Scalzo, Rebecca L.

AU - Johnston, Aspen

AU - Rafferty, Deirdre

AU - Schauer, Irene E.

AU - Whipple, Mary O.

AU - Hunter, Kendall

AU - Huebschmann, Amy G.

AU - Nadeau, Kristen J.

AU - Jarvis, Kelly

AU - Barker, Alex J.

AU - Regensteiner, Judith G.

AU - Reusch, Jane E.B.

PY - 2023/11/1

Y1 - 2023/11/1

N2 - Objective:Type 2 diabetes (T2D) and obesity are global epidemics leading to excess cardiovascular disease (CVD). This study investigates standard and novel cardiac MRI parameters to detect subclinical cardiac and central vascular dysfunction in inactive people with and without T2D.Methods:Physically inactive age and BMI-similar premenopausal women and men with (n = 22) and without [n = 34, controls with overweight/obesity (CWO)] uncomplicated T2D were compared to an age-similar and sex-similar reference control cohort (n = 20). Left ventricular (LV) structure, function, and aortic stiffness were assessed by MRI. Global arterial pulse wave velocity (PWV) was assessed using carotid-to-femoral applanation tonometry. Regional PWV was measured via 2D phase-contrast MRI and 4D flow MRI.Results:Global arterial PWV did not differ between CWO and T2D. 2D PC-MRI PWV in the ascending aorta was higher in people with T2D compared with CWOs (P < 0.01). 4D flow PWV in the thoracic aorta was higher in CWO (P < 0.01), and T2D (P < 0.001) compared with RC. End-diastolic volume, end-systolic volume, stroke volume, and cardiac output were lower in CWO and T2D groups compared with reference control.Conclusion:Subclinical changes in arterial stiffening and cardiac remodeling in inactive CWO and T2D compared with reference control support obesity and/or physical inactivity as determinants of incipient CVD complications in uncomplicated T2D. Future studies should determine the mechanistic causes of the CVD complications in greater detail in order to create therapeutic targets.Clinical Trial Registration:Cardiovascular Mechanisms of Exercise Intolerance in Diabetes and the Role of Sex (NCT03419195).

AB - Objective:Type 2 diabetes (T2D) and obesity are global epidemics leading to excess cardiovascular disease (CVD). This study investigates standard and novel cardiac MRI parameters to detect subclinical cardiac and central vascular dysfunction in inactive people with and without T2D.Methods:Physically inactive age and BMI-similar premenopausal women and men with (n = 22) and without [n = 34, controls with overweight/obesity (CWO)] uncomplicated T2D were compared to an age-similar and sex-similar reference control cohort (n = 20). Left ventricular (LV) structure, function, and aortic stiffness were assessed by MRI. Global arterial pulse wave velocity (PWV) was assessed using carotid-to-femoral applanation tonometry. Regional PWV was measured via 2D phase-contrast MRI and 4D flow MRI.Results:Global arterial PWV did not differ between CWO and T2D. 2D PC-MRI PWV in the ascending aorta was higher in people with T2D compared with CWOs (P < 0.01). 4D flow PWV in the thoracic aorta was higher in CWO (P < 0.01), and T2D (P < 0.001) compared with RC. End-diastolic volume, end-systolic volume, stroke volume, and cardiac output were lower in CWO and T2D groups compared with reference control.Conclusion:Subclinical changes in arterial stiffening and cardiac remodeling in inactive CWO and T2D compared with reference control support obesity and/or physical inactivity as determinants of incipient CVD complications in uncomplicated T2D. Future studies should determine the mechanistic causes of the CVD complications in greater detail in order to create therapeutic targets.Clinical Trial Registration:Cardiovascular Mechanisms of Exercise Intolerance in Diabetes and the Role of Sex (NCT03419195).

KW - aortic stiffness

KW - cardiac MRI

KW - heart failure

KW - obesity

KW - physical inactivity

KW - pulse wave velocity

KW - type 2 diabetes

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SN - 0263-6352

VL - 41

SP - 1775

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JO - Journal of hypertension

JF - Journal of hypertension

IS - 11

ER -

Obesity dominates early effects on cardiac structure and arterial stiffness in people with type 2 diabetes

Abstract

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ASJC Scopus subject areas

UN SDGs

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