D. Annane et al., CORRELATION BETWEEN DECREASED MYOCARDIAL GLUCOSE PHOSPHORYLATION AND THE DNA MUTATION SIZE IN MYOTONIC-DYSTROPHY, Circulation, 90(6), 1994, pp. 2629-2634
Background Myotonic dystrophy, the most common form of adult dystrophy
, has been shown to be caused by amplification of CTG triplet repeat i
n the 3' untranslated region of a protein kinase gene located on chrom
osome 19. Impaired glucose metabolism has been suggested as a possible
explanation of brain and skeletal muscle involvement in this multisys
tem disease. We investigated whether myocardial glucose metabolism is
impaired in myotonic dystrophy and whether this impairment is related
to the size of the mutation. Methods and Results The myocardial metabo
lic rate for glucose (MMRGlu, mu mol.min(-1).g(-1)), K1 (blood-to-tiss
ue transfer constant), k2 (tissue-to-blood transfer constant), and k3
(phosphorylation rate constant) were determined in 7 control subjects
and 12 patients with myotonic dystrophy by using parametric images gen
erated from dynamic cardiac positron emission tomography (PET) and F-1
8-fluoro-2-deoxyglucose studies. The expansion of the CTG triplet repe
ats was analyzed in patients with the probe cDNA25 after EcoRI digesti
on. Nonparametric tests were used to compare quantitative variables be
tween control subjects and patients. The correlations between the size
of the mutation and PET parameters were studied by linear regression.
MMRGlu and k3 were significantly decreased in patients compared with
control subjects (0.39+/-0.20 versus 0.64+/-0.25, P=.03, and 0.09+/-0.
07 versus 0.24+/-0.21, P=.03, respectively), whereas K1 and k2 were no
t statistically different between control subjects and patients. MMRGl
u and k3 correlate inversely with the length of the CTG triplet repeat
(r=-.65 and P=.03 for MMRGlu, and r=-.85 and P=.001 for k3, respectiv
ely). Conclusions In myotonic dystrophy, the observed reductions in MM
RGlu and phosphorylation are inversely linked to the length of the mut
ation. This observation suggests that impaired modulation of a protein
kinase involved in myocardial hexokinase activation may give a pathop
hysiological schema to relate the molecular defect and the abnormal my
ocardial metabolism in myotonic dystrophy.