{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T15:18:46Z","timestamp":1773933526704,"version":"3.50.1"},"reference-count":51,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2022,8,7]],"date-time":"2022-08-07T00:00:00Z","timestamp":1659830400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Carlos III Health Institute","award":["PI16\/02064"],"award-info":[{"award-number":["PI16\/02064"]}]},{"name":"Carlos III Health Institute","award":["PI20\/01588"],"award-info":[{"award-number":["PI20\/01588"]}]},{"name":"Carlos III Health Institute","award":["2017SGR1303"],"award-info":[{"award-number":["2017SGR1303"]}]},{"name":"European Regional Development","award":["PI16\/02064"],"award-info":[{"award-number":["PI16\/02064"]}]},{"name":"European Regional Development","award":["PI20\/01588"],"award-info":[{"award-number":["PI20\/01588"]}]},{"name":"European Regional Development","award":["2017SGR1303"],"award-info":[{"award-number":["2017SGR1303"]}]},{"DOI":"10.13039\/501100002809","name":"Agency for Management of University and Research Grants (AGAUR) of Catalonia","doi-asserted-by":"publisher","award":["PI16\/02064"],"award-info":[{"award-number":["PI16\/02064"]}],"id":[{"id":"10.13039\/501100002809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002809","name":"Agency for Management of University and Research Grants (AGAUR) of Catalonia","doi-asserted-by":"publisher","award":["PI20\/01588"],"award-info":[{"award-number":["PI20\/01588"]}],"id":[{"id":"10.13039\/501100002809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002809","name":"Agency for Management of University and Research Grants (AGAUR) of Catalonia","doi-asserted-by":"publisher","award":["2017SGR1303"],"award-info":[{"award-number":["2017SGR1303"]}],"id":[{"id":"10.13039\/501100002809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Background: We report that myocardial insulin resistance (mIR) occurs in around 60% of patients with type 2 diabetes (T2D) and was associated with higher cardiovascular risk in comparison with patients with insulin-sensitive myocardium (mIS). These two phenotypes (mIR vs. mIS) can only be assessed using time-consuming and expensive methods. The aim of the present study is to search a simple and reliable surrogate to identify both phenotypes. Methods: Forty-seven patients with T2D underwent myocardial [18F]FDG PET\/CT at baseline and after a hyperinsulinemic\u2013euglycemic clamp (HEC) to determine mIR were prospectively recruited. Biochemical assessments were performed before and after the HEC. Baseline hepatic steatosis index and index of hepatic fibrosis (FIB-4) were calculated. Furthermore, liver stiffness measurement was performed using transient elastography. Results: The best model to predict the presence of mIR was the combination of transaminases, protein levels, FIB-4 score and HOMA (AUC = 0.95; sensibility: 0.81; specificity: 0.95). We observed significantly higher levels of fibrosis in patients with mIR than in those with mIS (p = 0.034). In addition, we found that patients with mIR presented a reduced glucose uptake by the liver in comparison with patients with mIS. Conclusions: The combination of HOMA, protein, transaminases and FIB-4 is a simple and reliable tool for identifying mIR in patients with T2D. This information will be useful to improve the stratification of cardiovascular risk in T2D.<\/jats:p>","DOI":"10.3390\/ijms23158783","type":"journal-article","created":{"date-parts":[[2022,8,7]],"date-time":"2022-08-07T22:51:46Z","timestamp":1659912706000},"page":"8783","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Identification of Myocardial Insulin Resistance by Using Liver Tests: A Simple Approach for Clinical Practice"],"prefix":"10.3390","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7178-3290","authenticated-orcid":false,"given":"Jos\u00e9 Ra\u00fal","family":"Herance","sequence":"first","affiliation":[{"name":"Medical Molecular Imaging Research Group, Vall d\u2019Hebron Research Institute (VHIR), Nuclear Medicine, Radiology and Cardiology Departments, Vall d\u2019Hebron University Hospital, Autonomous University Barcelona, 08035 Barcelona, Spain"},{"name":"CIBERBBN (Instituto de Salud Carlos III), 28029 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4798-1558","authenticated-orcid":false,"given":"Queralt","family":"Mart\u00edn-Saladich","sequence":"additional","affiliation":[{"name":"Medical Molecular Imaging Research Group, Vall d\u2019Hebron Research Institute (VHIR), Nuclear Medicine, Radiology and Cardiology Departments, Vall d\u2019Hebron University Hospital, Autonomous University Barcelona, 08035 Barcelona, Spain"},{"name":"BCN Medtech Group, Information and Communication Technologies Department, Pompeu Fabra University, 08018 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mayra Alejandra","family":"Vel\u00e1squez","sequence":"additional","affiliation":[{"name":"Diabetes and Metabolism Research Group, Vall d\u2019Hebron Research Institute (VHIR), Endocrinology Department, Vall d\u2019Hebron University Hospital, Autonomous University Barcelona, 08035 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3109-1721","authenticated-orcid":false,"given":"Cristina","family":"Hernandez","sequence":"additional","affiliation":[{"name":"Diabetes and Metabolism Research Group, Vall d\u2019Hebron Research Institute (VHIR), Endocrinology Department, Vall d\u2019Hebron University Hospital, Autonomous University Barcelona, 08035 Barcelona, Spain"},{"name":"CIBERDEM (Instituto de Salud Carlos III), 28029 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carolina","family":"Aparicio","sequence":"additional","affiliation":[{"name":"Medical Molecular Imaging Research Group, Vall d\u2019Hebron Research Institute (VHIR), Nuclear Medicine, Radiology and Cardiology Departments, Vall d\u2019Hebron University Hospital, Autonomous University Barcelona, 08035 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clara","family":"Ramirez-Serra","sequence":"additional","affiliation":[{"name":"Clinical Biochemistry Research Group, Vall d\u2019Hebron Research Institute (VHIR), Biochemical Core Facilities, Vall d\u2019Hebron University Hospital, Autonomous University Barcelona, 08035 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8925-3172","authenticated-orcid":false,"given":"Roser","family":"Ferrer","sequence":"additional","affiliation":[{"name":"Clinical Biochemistry Research Group, Vall d\u2019Hebron Research Institute (VHIR), Biochemical Core Facilities, Vall d\u2019Hebron University Hospital, Autonomous University Barcelona, 08035 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marina","family":"Giralt-Arnaiz","sequence":"additional","affiliation":[{"name":"Clinical Biochemistry Research Group, Vall d\u2019Hebron Research Institute (VHIR), Biochemical Core Facilities, Vall d\u2019Hebron University Hospital, Autonomous University Barcelona, 08035 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9227-6826","authenticated-orcid":false,"given":"Miguel \u00c1ngel","family":"Gonz\u00e1lez-Ballester","sequence":"additional","affiliation":[{"name":"BCN Medtech Group, Information and Communication Technologies Department, Pompeu Fabra University, 08018 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3645-3293","authenticated-orcid":false,"given":"Juan M.","family":"Peric\u00e0s","sequence":"additional","affiliation":[{"name":"Liver Diseases Research Group, Vall d\u2019Hebron Research Institute (VHIR), Liver Unit, Vall d\u2019Hebron University Hospital, 08035 Barcelona, Spain"},{"name":"CIBEREHD (Instituto de Salud Carlos III), 28029 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joan","family":"Castell-Conesa","sequence":"additional","affiliation":[{"name":"Medical Molecular Imaging Research Group, Vall d\u2019Hebron Research Institute (VHIR), Nuclear Medicine, Radiology and Cardiology Departments, Vall d\u2019Hebron University Hospital, Autonomous University Barcelona, 08035 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Santiago","family":"Aguad\u00e9-Bruix","sequence":"additional","affiliation":[{"name":"Medical Molecular Imaging Research Group, Vall d\u2019Hebron Research Institute (VHIR), Nuclear Medicine, Radiology and Cardiology Departments, Vall d\u2019Hebron University Hospital, Autonomous University Barcelona, 08035 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0475-3096","authenticated-orcid":false,"given":"Rafael","family":"Sim\u00f3","sequence":"additional","affiliation":[{"name":"Diabetes and Metabolism Research Group, Vall d\u2019Hebron Research Institute (VHIR), Endocrinology Department, Vall d\u2019Hebron University Hospital, Autonomous University Barcelona, 08035 Barcelona, Spain"},{"name":"CIBERDEM (Instituto de Salud Carlos III), 28029 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,8,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"15019","DOI":"10.1038\/nrdp.2015.19","article-title":"Type 2 diabetes mellitus","volume":"1","author":"DeFronzo","year":"2015","journal-title":"Nat. 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