American Diabetes Association
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Intramyocellular Triglyceride Content During the Early Course of Type 1 and Type 2 Diabetes Mellitus

posted on 2023-07-21, 17:39 authored by Martin Schön, Oana P. Zaharia, Klaus Strassburger, Yuliya Kupriyanova, Kálmán Bódis, Geronimo Heilmann, Alexander Strom, Gidon J. Bönhof, Filippo Michelotti, Iryna Yurchenko, Clara Möser, Maximilian Huttasch, Maria Bombrich, Malte Kelm, Volker Burkart, Vera B. Schrauwen-Hinderling, Robert Wagner, Michael Roden, the GDS group

Intramyocellular lipid content (IMCL) is elevated in insulin-resistant humans, but its changes over time and relationships with comorbidities remain unclear. We examined IMCL during the initial course of diabetes and its associations with complications. Participants of the German Diabetes Study (GDS) with recent-onset type 1 (n=132) or type 2 diabetes (n=139) and glucose-tolerant controls (n=128) underwent 1H-magnetic resonance spectroscopy to measure IMCL and muscle volume, whole-body insulin sensitivity (hyperinsulinemic-euglycemic clamps; M-value) and cycling spiroergometry (VO2max). Subgroups underwent the same measurements after 5 years. At baseline, IMCL was ~30% higher in type 2 diabetes than in other groups independently of age, sex, BMI and muscle volume. In type 2 diabetes, M-value was ~36% and ~62% lower compared to type 1 diabetes and controls, respectively. After 5 years, M-value decreased by ~29% in type 1 and ~13% in type 2 diabetes, whereas IMCL remained unchanged. The correlation of IMCL and M-value in type 2 diabetes at baseline was modulated by VO2max. IMCL also associated with microalbuminuria, Framingham risk score for cardiovascular disease and cardiac autonomic neuropathy. Changes in IMCL within 5 years after diagnosis do not mirror progression of insulin resistance in type 2 diabetes but associate with early diabetes-related complications.


The research of M.R. is supported in part by grants from the German Federal Ministry of Health (BMG), the Ministry of Culture and Science of the State Northrhine Westphalia (MKW NRW) to the German Diabetes Center (DDZ) and the German Federal Ministry of Education and Research (BMBF) to German Center for Diabetes Research (DZD e. V.) as well as by grants from the European Community (HORIZON-HLTH-2022-STAYHLTH-02-01: Panel A) to the INTERCEPT-T2D consortium, EUREKA Eurostars-2 (E! 113230 DIA-PEP), German Science Foundation (DFG; CRC/SFB 1116/2 B12; RTG/GRK 2576 vivid, Project 3), Schmutzler Stiftung and the programme "Profilbildung 2020", an initiative of the Ministry of Culture and Science of the State of Northrhine Westphalia. The sole responsibility for the content of this publication lies with the authors.