Diabetes is hard on the heart — adults with diabetes die from heart disease about two to four times more often than those without diabetes. And scientific evidence has suggested that blood fat levels are a source of this problem.
Now a clinical study at Washington University School of Medicine in St. Louis is investigating the link between blood fat and heart health. “There is a growing appreciation that the kinds of metabolic changes found in diabetes can affect the heart,” says study leader Jean Schaffer, M.D., associate professor of medicine and a cardiologist at Barnes-Jewish Hospital. “People with diabetes tend to have higher levels of triglycerides and fatty acids in the blood, and we’re focusing on how this can alter heart muscle function.”
If you have type 2 diabetes and are otherwise healthy, you may be eligible to participate in the study. The researchers are looking for type 2 diabetics between the ages of 30 and 55 who don’t have severe hypertension, heart or valvular disease and don’t smoke.
“The study is very easy to participate in, requiring only two study visits,” says Schaffer, also associate professor of molecular biology and pharmacology. “Volunteers will contribute to our knowledge of heart disease and diabetes, and I find that many people with diabetes are very motivated to help push the envelope in research that can lead to new treatments.”
In an earlier study of mice, the research group found that when more fat entered heart muscle cells the mice developed problems with the relaxation phase of the heart’s pumping activity, even in the absence of blood sugar elevation. Abnormalities in the relaxation or diastolic phase of the heart cycle are often the earliest signs of heart problems in people with diabetes, according to Schaffer.
“This mouse study gave us further proof that fats alone could play an important role in these early heart problems,” Schaffer says. “So now we want to find out if people with diabetes who have elevated blood fat levels also show some of these early signs of heart dysfunction — even though they may not have any outward symptoms such as shortness of breath or fluid buildup.”
If the researchers can establish a clear link between high levels of fat and abnormal heart function, that would suggest diabetics could benefit greatly from new, more aggressive strategies to lower blood fat levels. “If we find an association between heart problems in diabetics and levels of lipids in the blood, then it would make all the more sense to try to lower lipids even further in people with diabetes. Moreover, this may spur further work on lipid-lowering agents that are well suited to diabetic patients,” Schaffer says.
Linda Peterson, M.D., assistant professor of medicine and a cardiologist at Barnes-Jewish Hospital, joins Schaffer in leading the study, which is part of a National Institutes of Health-funded program called Planning Interdisciplinary Studies of the Diabetic Heart. Daniel P. Kelly, M.D., the Alumni Endowed Professor of Cardiovascular Diseases and director of the Division of Cardiovascular Diseases, is principal investigator of the grant.
“We were one of the few institutions in the country that received this prestigious award for interdisciplinary studies,” Schaffer says. “It’s a great opportunity to move some of our basic laboratory observations into investigations in the clinical population.”
Participants in the study will undergo a physical exam and be asked to fill out a health questionnaire. Two 12-hour fasts before blood and urine tests are also required. Volunteers will receive $150 to compensate for their time and effort and will obtain a comprehensive evaluation of heart function and blood lipids. Anyone interested in the study can call coordinator Marsha Farmer at (314) 747-3357 or email her at mfarmer@im.wustl.edu.
Washington University School of Medicine’s full-time and volunteer faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Children’s hospitals. The School of Medicine is one of the leading medical research, teaching and patient care institutions in the nation, currently ranked fourth in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Children’s hospitals, the School of Medicine is linked to BJC HealthCare.