Background
Methods
Participants
Study procedures
Outcomes
CMR
CMR data analysis
PET
[11C]acetate PET scan
[15O]H2O PET scan
PET data analysis
Data analysis
Statistical analysis
Results
T2DM patients versus controls
Controls (n = 10) | T2DM patients (n = 26) | P | |
---|---|---|---|
Age, years | 59 ± 5 | 66 ± 5 | <0.01 |
Diabetes duration, years | NA | 8 (5–11) | NA |
Coronary artery disease, n (%) | NA | 24 (92%) | NA |
Male, n (%) | 10 (100) | 26 (100) | 1.00 |
BMI, kg m−2
| 29.4 ± 2.2 | 29.8 ± 3.1 | 0.74 |
Waist, cm | 103 ± 6 | 110 ± 10 | 0.04 |
Medication | |||
ACE inhibitor, n (%) | NA | 15 (56%) | NA |
Angiotensin II blocker, n (%) | NA | 10 (37%) | NA |
Beta blocker, n (%) | NA | 23 (85%) | NA |
Statins, n (%) | NA | 24 (89%) | NA |
Biochemical measurements (in fasten state) | |||
HbA1c, % | 5.5 ± 0.2 | 7.5 ± 1.3 | <0.01 |
Plasma glucose, mmol L−1
| 5.5 ± 0.3 | 9.7 ± 2.6 | <0.01 |
Total cholesterol, mmol L−1
| 5.7 ± 0.7 | 4.3 ± 1.0 | <0.01 |
HDL cholesterol, mmol L−1
| 1.4 (1.2–1.5) | 1.0 (0.9–1.2) | <0.01 |
LDL cholesterol, mmol L | 3.9 ± 0.7 | 2.3 ± 0.9 | <0.01 |
Triglycerides, mmol L−1
| 1.1 (0.9–1.2) | 1.6 (1.1–2.1) | 0.02 |
Non-esterified fatty acids, mmol L−1
| 0.4 ± 0.1 | 0.5 ± 0.2 | 0.03 |
eGFR (MDRD), mL min−1 1.73 m−2
| 89 ± 14 | 86 ± 28 | 0.80 |
Albumin-to-creatinin ratio, g mol−1
| 0.4 (0.3–0.5) | 1.3 (0.6–2.4) | <0.01 |
Controls (n = 10) | T2DM patients (n = 26) | P | |
---|---|---|---|
Heart rate, beats min−1
| |||
Rest | 55 ± 3 | 64 ± 11 | <0.01 |
Hyperemia | 76 ± 10 | 79 ± 13 | 0.42 |
P-value | <0.01 | <0.01 | |
Systolic blood pressure, mmHg | |||
Rest | 116 ± 6 | 127 ± 17 | 0.01 |
Hyperemia | 129 ± 11 | 131 ± 19 | 0.68 |
P-value | <0.01 | 0.12 | |
Diastolic blood pressure, mmHg | |||
Rest | 71 ± 6 | 66 ± 10 | 0.26 |
Hyperemia | 74 ± 6 | 67 ± 8 | 0.02 |
P-value | 0.21 | 0.47 | |
Mean arterial pressure, mmHg | |||
Rest | 86 ± 5 | 87 ± 12 | 0.72 |
Hyperemia | 92 ± 5 | 89 ± 11 | 0.17 |
P-value | 0.02 | 0.23 | |
Rate pressure product, mm Hg min−1
| |||
Rest | 6318 ± 515 | 8050 ± 1430 | <0.01 |
Hyperemia | 9673 ± 1123 | 10,355 ± 2217 | 0.23 |
P-value | <0.01 | <0.01 |
Controls (n = 10) | T2DM patients (n = 26) | P | |
---|---|---|---|
CMR | |||
LVEDV, mL | 202 ± 36 | 209 ± 70 | 0.79 |
LVESV, mL | 83 ± 18 | 117 ± 75 | 0.19 |
LV mass, g | 123 ± 25 | 116 ± 27 | 0.51 |
LVEF, % | 59 ± 4 | 47 ± 13 | <0.01 |
DCE, g | 0 | 6.3 (0–11.3) | <0.01 |
PET | |||
MBF, rest, mL−1 min−1 g−1
| 0.75 ± 0.07 | 0.86 ± 0.19 | 0.02 |
MBF, rest, corrected for RPP, mL min−1 g−1
| 1.22 ± 0.1 | 1.11 ± 0.4 | 0.20 |
MBF, stress, mL min−1 g−1
| 2.64 ± 0.28 | 2.05 ± 0.65 | <0.01 |
CFR | 3.54 ± 0.54 | 2.43 ± 0.79 | <0.01 |
CFR, corrected for RPP, mmHg min−1
| 2.20 ± 0.35 | 1.97 ± 0.74 | 0.56 |
External work, Joule | 1.26 ± 0.26 | 1.00 ± 0.31 | 0.04 |
MVO2, mL g−1 min−1
| 0.09 ± 0.01 | 0.08 ± 0.01 | 0.23 |
Myocardial efficiency, % | 32 ± 6 | 35 ± 9 | 0.39 |
Effects of exenatide and insulin glargine in T2DM patients
Exenatide (n = 11) | Insulin glargine (n = 12) | P between groups | ||||||
---|---|---|---|---|---|---|---|---|
Baseline | Follow-up | P | Baseline | Follow-up | P | Baseline | Follow-up | |
BMI, kg m−2
| 29.0 ± 2.6 | 27.6 ± 3.1 | <0.01 | 29.9 ± 3.3 | 30.0 ± 3.6 | 0.80 | 0.47 | <0.01 |
Waist, cm | 108 ± 9 | 104 ± 10.3 | <0.01 | 109 ± 10 | 110 ± 10 | 0.53 | 0.79 | <0.01 |
Biochemical measurements (in fasten state) | ||||||||
HbA1c, % | 7.7 ± 1.7 | 7.1 ± 1.9 | <0.01 | 7.5 ± 0.8 | 6.8 ± 0.7 | <0.01 | 0.68 | 0.49 |
Plasma glucose, mmol L−1
| 10.4 ± 3.7 | 9.5 ± 4.0 | 0.14 | 9.3 ± 1.6 | 7.1 ± 1.2 | <0.01 | 0.36 | 0.03 |
Total cholesterol, mmol L−1
| 4.1 ± 1.2 | 3.8 ± 0.9 | 0.04 | 4.3 ± 0.9 | 4.1 ± 0.9 | 0.06 | 0.74 | 0.25 |
HDL cholesterol, mmol L−1
| 0.9 (0.7–1.2) | 0.9 (0.8–1.2) | 0.92 | 1.0 (0.9–1.1) | 1.0 (1.0–1.1) | 0.29 | 0.54 | 0.24 |
LDL cholesterol, mmol L−1
| 1.9 ± 1.1 | 1.8 ± 0.9 | 0.22 | 2.5 ± 0.7 | 2.4 ± 0.8 | 0.17 | 0.17 | 0.65 |
Triglycerides, mmol L−1
| 1.8 (1.0–3.0) | 1.2 (0.9–1.7) | 0.04 | 1.8 (1.1–2.1) | 1.4 (0.9–1.6) | 0.11 | 0.87 | 0.33 |
Non-esterified fatty acids, mmol L−1
| 0.6 ± 0.1 | 0.5 ± 0.2 | 0.27 | 0.5 ± 0.1 | 0.4 ± 0.1 | 0.09 | 0.09 | 0.48 |
eGRF (MDRD), mL min−1 1.73 m−2
| 90 ± 35 | 89 ± 26 | 0.65 | 82 ± 22 | 86 ± 26 | 0.29 | 0.52 | 0.37 |
Albumin-to-creatinin ratio, g mol−1
| 0.7 (0.4–1.3) | 0.6 (0.4–0.7) | 0.88 | 1.5 (0.7–3.3) | 1.2 (0.7–3.5) | 0.14 | 0.09 | 0.31 |
Exenatide (n = 11) | Insulin glargine (n = 12) | P between groups | ||||||
---|---|---|---|---|---|---|---|---|
Baseline | Follow-up | P | Baseline | Follow-up | P | Baseline | Follow-up | |
CMR | ||||||||
LVEDV, mL | 176 ± 42 | 175 ± 31 | 0.90 | 206 ± 38 | 206 ± 44 | 0.93 | 0.10 | 0.49 |
LVESV, mL | 86 ± 26 | 86 ± 25 | 1.00 | 104 ± 29 | 109 ± 31 | 0.11 | 0.13 | 0.25 |
LV mass, g | 110 ± 29 | 105 ± 20 | 0.31 | 113 ± 23 | 118 ± 23 | 0.27 | 0.82 | 0.05 |
LVEF, % | 51 ± 7 | 52 ± 7 | 0.85 | 50 ± 9 | 47 ± 10 | 0.06 | 0.58 | 0.11 |
DCE, g | 9.5 (1.0–11.4) | 8.8 (2.2–14.0) | 0.74 | 10.5 (5.8–21.7) | 14.1 (5.3–27.4) | 0.07 | 0.33 | 0.17 |
PET | ||||||||
MBF, rest, mL min−1 g−1
| 0.92 ± 0.18 | 0.86 ± 0.11 | 0.33 | 0.80 ± 0.18 | 0.86 ± 0.17 | 0.31 | 0.15 | 0.57 |
MBF, rest, corrected for RPP, mL min−1 g−1
| 1.25 ± 0.46 | 1.03 ± 0.26 | 0.04 | 1.02 ± 0.26 | 0.98 ± 0.16 | 0.59 | 0.16 | 0.45 |
MBF, stress, mL min−1 g−1
| 2.29 ± 0.53 | 2.20 ± 0.59 | 0.57 | 2.00 ± 0.68 | 1.94 ± 0.62 | 0.46 | 0.28 | 0.79 |
CFR | 2.59 ± 0.82 | 2.60 ± 0.89 | 0.96 | 2.51 ± 0.72 | 2.24 ± 0.59 | 0.20 | 0.82 | 0.22 |
CFR, corrected for RPP, mmHg min−1
| 2.03 ± 0.76 | 2.26 ± 0.79 | 0.19 | 2.04 ± 0.77 | 1.98 ± 0.62 | 0.65 | 0.96 | 0.16 |
External work, Joule | 1.06 ± 0.38 | 0.98 ± 0.20 | 0.35 | 1.12 ± 0.34 | 1.12 ± 0.34 | 0.99 | 0.70 | 0.21 |
MVO2, mL g−1 min−1
| 0.08 ± 0.01 | 0.08 ± 0.01 | 0.52 | 0.08 ± 0.01 | 0.07 ± 0.02 | 0.23 | 0.28 | 0.48 |
Myocardial efficiency, % | 36 ± 8 | 38 ± 6 | 0.53 | 39 ± 8 | 40 ± 11 | 0.59 | 0.45 | 0.84 |