• Eur. J. Intern. Med. · Sep 2024

    Impaired insulin sensitivity measured by estimated glucose disposal rate is associated with decreased myocardial mechano-energetic efficiency in non-diabetic individuals.

    • Chiara M A Cefalo, Alessia Riccio, Teresa Vanessa Fiorentino, Elena Succurro, Maria Perticone, Angela Sciacqua, Francesco Andreozzi, and Giorgio Sesti.
    • Department of Clinical and Molecular Medicine, University of Rome-Sapienza, 00189, Rome, Italy. Electronic address: chiaramariaassunta@uniroma1.it.
    • Eur. J. Intern. Med. 2024 Sep 16.

    Background And AimsImpaired myocardial mechano-energetic efficiency (MEE) has been associated with cardiac insulin resistance measured by dynamic positron emission tomography (PET) with 18F-fluorodeoxyglucose (18F-FDG) combined with euglycemic-hyperinsulinemic clamp. Estimate glucose disposal rate (eGDR) index has a good correlation with whole-body insulin sensitivity. It remains unsettled whether eGDR index is a suitable proxy of cardiac insulin sensitivity as well as its association with myocardial MEE. The aims of this study were: 1) to compare eGDR index with HOMA-IR, QUICKI and FIRI indexes for association with myocardial glucose metabolic rate (MrGlu); and 2) to determine the association of eGDR index with myocardial MEE.MethodsWe evaluated MrGlu using PET with 18F-FDG combined with euglycemic-hyperinsulinemic clamp in 50 individuals without history of coronary heart disease. Myocardial MEE per gram of left ventricular mass (MEEi) was measured in 1181 subjects by echocardiography. eGDR (mg kg-1/min) was calculated as: 21.158 - (0.09 × waist circumference in cm) - (3.407 × hypertension, 1 = yes 0 = no) - (0.551 × HbA1c%).ResultseGDR index was more strongly associated with myocardial MrGlu than HOMA-IR, QUICKI, and FIRI indexes (r = -0.662, r = -0.492, r = 0.570, and r = -0.492, respectively). Individuals in the lower tertiles of eGDR exhibited a significant reduction of MEEi as compared to those in the highest tertile (P < 0.001). In a stepwise multivariate linear regression analysis eGDR index was the major determinant of MEEi independently of well-established cardio-metabolic risk factors.ConclusionsThese data suggest that the eGDR index may be a useful marker to identifying individuals at high cardiovascular risk.Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.

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