Increased mediastinal fat and impaired left ventricular energy metabolism in young men with newly found fatty liver

Authors

  • Gianluca Perseghin,

    Corresponding author
    1. Department of Internal Medicine, Section of Nutrition/Metabolism, San Raphael Scientific Institute, Milan, Italy
    2. Unit of Clinical Spectroscopy, San Raphael Scientific Institute, Milan, Italy
    3. Faculty of Exercise Sciences, Università degli Studi di Milano, Milan, Italy
    4. Center “Physical exercise for health and wellness of the Faculty of Exercise Sciences,” Università degli Studi di Milano, Milan, Italy
    • Faculty of Exercise Sciences, Università degli Studi di Milano and Internal Medicine/Unit of Clinical Spectroscopy Istituto Scientifico San Raffaele, via Olgettina 60, 20132, Milano, Italy
    Search for more papers by this author
    • fax: (39) 02 2643-2771

  • Guido Lattuada,

    1. Department of Internal Medicine, Section of Nutrition/Metabolism, San Raphael Scientific Institute, Milan, Italy
    Search for more papers by this author
  • Francesco De Cobelli,

    1. Unit of Clinical Spectroscopy, San Raphael Scientific Institute, Milan, Italy
    2. Division of Diagnostic Radiology, San Raphael Scientific Institute, Milan, Italy
    Search for more papers by this author
  • Antonio Esposito,

    1. Division of Diagnostic Radiology, San Raphael Scientific Institute, Milan, Italy
    Search for more papers by this author
  • Elena Belloni,

    1. Division of Diagnostic Radiology, San Raphael Scientific Institute, Milan, Italy
    Search for more papers by this author
  • Georgia Ntali,

    1. Department of Internal Medicine, Section of Nutrition/Metabolism, San Raphael Scientific Institute, Milan, Italy
    Search for more papers by this author
    • She is currently a clinical fellow in the Department of Endocrinology, Polikliniki Hospital, Athens.

  • Francesca Ragogna,

    1. Department of Internal Medicine, Section of Nutrition/Metabolism, San Raphael Scientific Institute, Milan, Italy
    Search for more papers by this author
  • Tamara Canu,

    1. Division of Diagnostic Radiology, San Raphael Scientific Institute, Milan, Italy
    Search for more papers by this author
  • Paola Scifo,

    1. Unit of Clinical Spectroscopy, San Raphael Scientific Institute, Milan, Italy
    2. Division of Nuclear Medicine, Raphael Scientific Institute, Milan, Italy
    Search for more papers by this author
  • Alessandro Del Maschio,

    1. Unit of Clinical Spectroscopy, San Raphael Scientific Institute, Milan, Italy
    2. Division of Diagnostic Radiology, San Raphael Scientific Institute, Milan, Italy
    3. Università Vita e Salute San Raffaele, Milan, Italy
    Search for more papers by this author
  • Livio Luzi

    1. Department of Internal Medicine, Section of Nutrition/Metabolism, San Raphael Scientific Institute, Milan, Italy
    2. Unit of Clinical Spectroscopy, San Raphael Scientific Institute, Milan, Italy
    3. Faculty of Exercise Sciences, Università degli Studi di Milano, Milan, Italy
    4. Center “Physical exercise for health and wellness of the Faculty of Exercise Sciences,” Università degli Studi di Milano, Milan, Italy
    Search for more papers by this author

  • Potential conflict of interest: Nothing to report.

Abstract

Fatty liver is characterized by metabolic abnormalities at the liver, but also at skeletal muscle and adipose tissue sites. It is hypothesized that the heart may be suffering metabolic alterations, and this study was undertaken to ascertain whether individuals with fatty liver have left ventricular (LV) alterations of energy metabolism, structure, and function and abnormal amounts of epicardial fat as a specific marker of visceral fat accumulation. To this end we studied young, nondiabetic men matched for anthropometric features with (n = 21) or without (n = 21) fatty liver by means of (1) cardiac magnetic resonance imaging (MRI); (2) cardiac 31P-MR spectroscopy (MRS); and (3) hepatic 1H-MRS to assess quantitatively the intrahepatic fat (IHF) content. Insulin sensitivity was determined by the updated HOMA-2 computer model. Individuals with fatty liver showed reduced insulin sensitivity, increased serum free fatty acid (FFA), and E-selectin, abnormal adipokine concentrations, and higher blood pressure. LV morphology and systolic and diastolic functions were not different; however, in the scanned intrathoracic region, the intrapericardial (7.8 ± 3.1 versus 5.9 ± 2.5 cm2; P < 0.05) and extrapericardial (11.7 ± 6.1 versus 7.8 ± 3.2 cm2; P < 0.03) fat was increased in men with fatty liver compared with those without fatty liver. The phosphocreatine (PCr)/adenosine triphosphate (ATP) ratio, a recognized in vivo marker of myocardial energy metabolism, was reduced in men with fatty liver in comparison with normals (1.85 ± 0.35 versus 2.11 ± 0.31; P < 0.016). In conclusion, in newly found individuals with fatty liver, fat was accumulated in the epicardial area and despite normal LV morphological features and systolic and diastolic functions, they had abnormal LV energy metabolism. (HEPATOLOGY 2008.)

Ancillary