LEUTNER Michael

The Association of Ectopic Lipids and Insulin Resistance with Special Focus on Prediabetic Individuals, Type-2 Diabetic Patients and Women with the Polycystic Ovary Syndrome

The number of diabetic patients worldwide was more than 382 million and experts calculate that this number will increase up to 592 million in 2025. 2013 the amount of money spent on diabetes was 548 Mrd. US-dollars. In Austria the number of diabetic patients is nowadays approximately 600.000 which corresponds to 8-9% of the general population. Gender is very important regarding the diabetes disease. Biological factors such as fluctuation of sexual hormones, as well as cultural and gender-specific rolls can have immense influence on the diabetes disease. Diabetes mellitus is one of the most noncummunicable diseases worldwide. Diabetes mellitus leads to a high number of utilization of medical services which leads in further consequence to high costs. The earlier the diabetes disease is diagnosed the lower the risk for secondary diseases of diabetes such as nephropathia, stroke or heart attacks is. Epigenetic is an interesting point for the investigation of early and non-invasive diagnosis and the prognosis of type 2 diabetes. Reddy et al demonstrated the important role of epigenetic and epigenomic regarding the association to diabetes and diabetes specific secondary diseases. Additionally del Rosario et al. demonstrated a association of gestational diabetes in humans and animals with epigenetics. Up to now there exist no diabetes specific tests for the early detection of the disease. Regarding early detection tests for diabetes out of body fluids there are only examples in the area of microRNA´s. Ectopic lipids got more and more importance regarding insulin resistance in the last years. There is data available which shows that ectopic lipids for example in the heart are more sensitive markers for insulin resistance compared with visceral adipose tissue.

The objective of the project "Associatons of PCOS Phenotypes with Ectopic Lipids, Adipocytokines and Parameters of Insulin Resistance" funded by the Scientific Fund of the Mayor of Vienna is to find early diabetes specific biomarkers in blood plasma which correlate with insulin resistance and ectopic lipids of the heart. The specific population of women with PCOS have a high risk for the development of insulin resistance and in further consequence for the development of diabetes. To get information about the glucose metabolism an oral glucose tolerance test with an additional analysis of routine blood parameters will be done. Due to existing data, that ectopic lipids correlate significantly with insulin resistance a magnetresonance spectroscopy in order to analyse intracardiac fat will be done. The major objective is to find early detection markers of insulin resistance and biomarkers which correlate with ectopic lipids of the heart.

The project "epigenetic-based type 2 diabetes diagnostic in saliva and blood plasma", funded by FEMtech, aims to investigate early epigenetic modifications in the blood and the saliva in different forms of diabetes mellitus (type 2 diabetes, prediabetes and gestational diabetes). The objective of this project is to find gender-specific biomarkers in the blood and the saliva of patients with type-2-diabetes, prediabetes and women with gestational diabetes, for the early detection of the diagnosis of diabetes. Routine blood analyses will be realized and saliva samples of the study participants will be removed. This project is a cooperation with the Austrian Institute of Technology who will analyse the saliva- and the plasma-samples on new biomarkers. Additionally a magnetresonance spectroscopy for the analysis of intrahepatic- and intracardial fat will be done.
In further consequence the analysed biomarkers will be put in correlation with ectopic lipids of the liver and the heart.

All projects will serve as basis for the PhD thesis "The association of ectopic lipids and insulin resistance with special focus on prediabetic individuals, type-2 diabetic patients and women with the polycystic ovary syndrome" as they all follow the big aim to analyse preventive biomarkers which correlate with insulin resistance and with ectopic lipids.

Methods and Skills:

Clinical studies; magnetic resonance spectroscopy; gender medicine

Publications:

Leutner M, Göbl C, Wielandner A, Howorka E, Prünner M, Bozkurt L, Schlager O, Charwat-Resl S, Kautzky-Willer A. Clinical and metabolic characteristics of treated hyperlipidemic patients additionally affected by subclinical hyperglycemia. Lipids Health Dis. 15: doi: 10.1186/s12944-016-0180-0, 2016

Göbl CS, Bozkurt L, Mittlböck M, Leutner M, Yarragudi R, Tura A, Pacini G, Kautzky-Willer A. To explain the variation of OGTT dynamics by biological mechanisms: a novel approach based on principal components analysis in women with history of GDM. Am J Physiol - Regul Integr Comp Physiol 309: R13-21, 2015