The prevalence of obesity, defined as a body mass index (BMI) > 30 kg/m2, is increasing to epidemic proportions. In 2014, 11% of men and 15% of women worldwide were obese. Thus, more than... Show moreThe prevalence of obesity, defined as a body mass index (BMI) > 30 kg/m2, is increasing to epidemic proportions. In 2014, 11% of men and 15% of women worldwide were obese. Thus, more than half a billion adults worldwide are classed as obese. The fundamental cause of obesity is an imbalance between energy intake (excessive intake of energy-dense foods) and energy expenditure (reduced physical activity). People with obesity are at risk for a range of chronic conditions including cardiovascular disease (CVD) and nonalcoholic fatty liver disease (NAFLD). Furthermore, obesity is a major risk factor for the development of type 2 diabetes, which is one of the most common chronic diseases in nearly all countries. According to the World Health Organization, the global prevalence of diabetes in 2014 was estimated to be 9%, of which 90% was comprised of type 2 diabetes. This thesis focuses on cardiovascular and cerebral dimensions and function in people with obesity and type 2 diabetes. State-of-the-art imaging techniques are used to investigate links between the heart, liver, abdominal fat, and brain to elucidate parts of the complex relationships between these organs. Show less
The aim of the thesis was to provide more insight into the influence of myocardial steatosis on left ventricular function in healthy volunteers and in patients with type 2 diabetes mellitus.... Show moreThe aim of the thesis was to provide more insight into the influence of myocardial steatosis on left ventricular function in healthy volunteers and in patients with type 2 diabetes mellitus. Therefore we developed a reproducible proton magnetic resonance (MR) spectroscopic technique with respiratory motion compensation to study myocardial steatosis. Using these technique, combined with MR imaging to study myocardial function, correlations between myocardial steatosis and left ventricular function were shown in several (patho)physiological conditions. Furthermore, we showed that myocardial triglyceride content is increased in patients with type 2 diabetes mellitus and is an independent predictor of left ventricular diastolic dysfunction. In addition, differential, tissue-specific partitioning of triglycerides and/or fatty acids among non-adipose organs during various diets was shown. Given the obesity and type 2 diabetes mellitus pandemic and the increasing evidence indicating that lipid oversupply to cardiomyocytes plays a role in the development of diabetic cardiomyopathy, therapeutic strategies that target reduction of cardiac lipid overexposure might be beneficial to prevent diabetic cardiomyopathy. Show less
