Insulin resistance is the best prediction factor for the clinical onset of type 2 diabetes. It was suggested that intramuscular triglyceride store may be a primary pathogenic factor for its development. To test this hypothesis, 14 young lean offspring of type 2 diabetic parents, a model of in vivo insulin resistance with increased risk to develop diabetes, and 14 healthy subjects matched for anthropomorphic parameters and life habits were studied with 1) euglycemic-hyperinsulinemic clamp to assess whole body insulin sensitivity, 2) localized 1H nuclear magnetic resonance (NMR) spectroscopy of the soleus (higher content of fiber type I, insulin sensitive) and tibialis anterior (higher content of fiber type IIb, less insulin sensitive) muscles to assess intramyocellular triglyceride content, 3) 13C NMR of the calf subcutaneous adipose tissue to assess composition in saturated/unsaturated carbons of triglyceride fatty acid chains, and 4) dual X-ray energy absorption to assess body composition. Offspring of diabetic parents, notwithstanding normal fat content and distribution, were characterized by insulin resistance and increased intramyocellular triglyceride content in the soleus (P < 0.01) but not in the tibialis anterior (P = 0.19), but showed a normal content of saturated/unsaturated carbons in the fatty acid chain of subcutaneous adipocytes. Stepwise regression analysis selected intramyocellular triglyceride soleus content and plasma free fatty acid levels as the main predictors of whole body insulin sensitivity. In conclusion, 1H and 13C NMR spectroscopy revealed intramyocellular abnormalities of lipid metabolism associated with whole body insulin resistance in subjects at high risk of developing diabetes, and might be useful tools for noninvasively monitoring these alterations in diabetes and prediabetic states.

MRI was more sensitive than mammography for the detection of multiple malignant foci in fibroglandular or dense breasts. Mammography missed larger and more invasive cancer foci than MRI. A relatively low PPV was a problem for both techniques.

: MRI largely outperformed mammography, ultrasonography, and their combination for screening high-risk women below and over 50.

OBJECTIVE -Fatty liver may be involved in the pathogenesis of type 2 diabetes. Physical exercise is a tool to improve insulin sensitivity, but little is known about its effect on intrahepatic fat (IHF) content. The purpose of this study was to examine the association of habitual physical activity, insulin resistance, and adiponectin with IHF content.RESEARCH DESIGN AND METHODS -Participants were 191 (77 female and 114 male) apparently healthy, nonalcoholic individuals (aged 19 -62 years; BMI 17.0 -35.5 kg/m 2 ). IHF content was assessed in a quantitative fashion and noninvasively as a continuous variable by means of 1 H magnetic resonance spectroscopy (MRS), and habitual physical activity was assessed by means of a questionnaire. Fatty liver was defined as IHF content of Ͼ5% wet weight, and insulin sensitivity was estimated using the computer homeostasis model assessment (HOMA)-2 indexes.RESULTS -A reduced prevalence of fatty liver in the quartile of the most physically active individuals (25,11,25, and 2% in quartile 1, 2, 3, and 4, respectively; 2 ϭ 15.63; P ϭ 0.001) was found along with an inverse correlation between the physical activity index and the IHF content when plotted as continuous variables (Pearson's r ϭ Ϫ0.27; P Ͻ 0.000). This association was not attenuated when adjusted for age, sex, BMI, HOMA-2, and adiponectin (partial correlation r ϭ Ϫ0.25; P Ͻ 0.001).CONCLUSIONS -This study demonstrated that a higher level of habitual physical activity is associated with a lower IHF content and suggested that this relationship may be due to the effect of exercise per se. Diabetes Care 30:683-688, 2007A lanine aminotransferase and ␥-glutamyltransferase are associated with type 2 diabetes risk (1-3), and it is thought that the link is represented by the intrahepatic fat (IHF) content. Ectopic fat accumulation within the liver, in fact, has been reported in association with impairment of insulin-stimulated glucose metabolism, of suppression of endogenous glucose production, and of whole-body lipolysis in nondiabetic individuals with nonalcoholic fatty liver disease (NAFLD) (4,5). Additional results also demonstrated that decreased levels of circulating adiponectin in NAFLD are related to hepatic insulin sensitivity and to the IHF content, suggesting that hypoadiponectinemia may be involved in excessive hepatic fat accumulation (6).Physical exercise was found to be associated with a reduced risk of development of type 2 diabetes (7,8) and is a wellrecognized tool to improve insulin sensitivity at the level of the skeletal muscle (9). However, whether physical exercise may affect insulin sensitivity and diabetes risk via an effect on the IHF content and adiponectin remains unknown.The IHF content may be assessed as a continuous variable by means of 1 H magnetic resonance spectroscopy (MRS) (10), and recently this technique was found to be a sensitive, quantitative, and noninvasive method also when applied to a large population (11) without the need for the use of a more invasive approach such as liver biopsy. The ...

The mechanics of blood flow in arteries plays a key role in the health of individuals. In this framework, the role played by the presence of helical flow in the human aorta is still not clear in its relation to physiology and pathology. We report here a method for quantifying helical flow in vivo employing time-resolved cine phase contrast magnetic resonance imaging to obtain the complete spatio-temporal description of the three-dimensional pulsatile blood flow patterns in aorta. The method is applied to data of one healthy volunteer. Particle traces were calculated from velocity data: to them we applied a Lagrangian-based method for helical flow quantification, the Helical Flow Index, which has been developed and evaluated in silico in order to reveal global organization of blood flow. Our results: (i) put in evidence that the systolic hemodynamics in aorta is characterized by an evolving helical flow (we quantified a 24% difference in terms of the content of helicity in the streaming blood, between mid and early systole); (ii) indicate that in the first part of the systole helicity is ascrivable mainly to the asymmetry of blood flow in the left ventricle, joined with the laterality of the aorta. In conclusion, this study shows that the quantification of helical blood flow in vivo is feasible, and it might allow detection of anomalies in the expected physiological development of helical flow in aorta and accordingly, could be used in a diagnostic/prognostic index for clinical practice.