Tissue sodium content in patients with type 2 diabetes mellitus

BACKGROUND

Tissue sodium content by ²³Na magnetic resonance imaging (MRI) has been found to be increased in arterial hypertension. We analyzed whether tissue sodium content is increased in patients with type-2 diabetes (T2DM).

METHODS

Patients with T2DM were compared to those with primary hypertension. Patients with T2DM were off any antidiabetic and hypertensive patients off any antihypertensive therapy for at least 4 weeks. Skin and muscle sodium content was assessed non-invasively with a 3.0 T clinical MRI system (Magnetom Verio, Siemens Health Care, Erlangen, Germany) in each patient.

RESULTS

In patients with T2DM (N = 59) we observed significantly greater muscle sodium content (diabetes: 20.6 ± 3.5 vs hypertension: 16.3 ± 2.5 mmol/l, p < 0.001) and skin sodium content (diabetes: 24.5 ± 7.2 vs hypertension: 20.6 ± 5.7 mmol/l, p = 0.01) than in those with primary hypertension (N = 33). When potential confounders (age, body mass index, gender, systolic and diastolic blood pressure, estimated glomerular filtration rate) were entered in a covariance analysis, both skin sodium content (p = 0.037) and muscle sodium content (p < 0.001) were still clearly elevated.

CONCLUSION

Patients with T2DM have greater skin and muscle sodium content. These are the first known data to demonstrate increased tissue sodium content in patients with T2DM, measured by ²³Na magnetic resonance imaging. Since tissue sodium content is related to organ damage, therapeutic intervention should aim at reducing tissue sodium content.

Sodium 3D COncentration MApping (COMA 3D) using (23)Na and proton MRI

Functional changes of sodium 3D MRI signals were converted into millimolar concentration changes using an open-source fully automated MATLAB toolbox. These concentration changes are visualized via 3D sodium concentration maps, and they are overlaid over conventional 3D proton images to provide high-resolution co-registration for easy correlation of functional changes to anatomical regions. Nearly 5000/h concentration maps were generated on a personal computer (ca. 2012) using 21.1T 3D sodium MRI brain images of live rats with spatial resolution of 0.8×0.8×0.8 mm(3) and imaging matrices of 60×60×60. The produced concentration maps allowed for non-invasive quantitative measurement of in vivo sodium concentration in the normal rat brain as a functional response to migraine-like conditions. The presented work can also be applied to sodium-associated changes in migraine, cancer, and other metabolic abnormalities that can be sensed by molecular imaging. The MATLAB toolbox allows for automated image analysis of the 3D images acquired on the Bruker platform and can be extended to other imaging platforms. The resulting images are presented in a form of series of 2D slices in all three dimensions in native MATLAB and PDF formats. The following is provided: (a) MATLAB source code for image processing, (b) the detailed processing procedures, (c) description of the code and all sub-routines, (d) example data sets of initial and processed data. The toolbox can be downloaded at: http://www.vuiis.vanderbilt.edu/~truongm/COMA3D/.

Optic nerve: separating compartments based on 23Na TQF spectra and TQF-diffusion anisotropy

We present a triple quantum filtered (TQF) sodium spectroscopy study of an excised bovine optic nerve. By choosing proper experimental parameters, this technique allowed us to independently observe the satellite transitions originating from the various compartments in the tissue. TQF-based diffusion experiments provided further characterization of the compartments in terms of their geometry. As a result, the peak that exhibited the smallest residual quadrupolar splitting, and the largest diffusion anisotropy was assigned to axons. Two other pairs of satellite peaks were assigned to extra-cellular compartments on the basis of either the size of their quadrupolar splitting or the diffusion properties.

Discrimination of intra- and extracellular 23Na+ signals in yeast cell suspensions using longitudinal magnetic resonance relaxography

This study tested the ability of MR relaxography (MRR) to discriminate intra- (Nai+) and extracellular (Nae+)23Na+ signals using their longitudinal relaxation time constant (T1) values. Na+-loaded yeast cell (Saccharomyces cerevisiae) suspensions were investigated. Two types of compartmental 23Na+T1 differences were examined: a selective Nae+T1 decrease induced by an extracellular relaxation reagent (RRe), GdDOTP5-; and, an intrinsic T1 difference. Parallel studies using the established method of 23Na MRS with an extracellular shift reagent (SRe), TmDOTP5-, were used to validate the MRR measurements. With 12.8 mM RRe, the 23Nae+T1 was 2.4 ms and the 23Nai+T1 was 9.5 ms (9.4 T, 24 degrees C). The Na+ amounts and spontaneous efflux rate constants were found to be identical within experimental error whether measured by MRR/RRe or by MRS/SRe. Without RRe, the Na+-loaded yeast cell suspension 23Na MR signal exhibited two T1 values, 9.1 (+/-0.3) ms and 32.7 (+/-2.3) ms, assigned to 23Nai+ and 23Nae+, respectively. The Nai+ content measured was lower, 0.88 (+/-0.06); while Nae+ was higher, 1.43 (+/-0.12) compared with MRS/SRe measures on the same samples. However, the measured efflux rate constant was identical. T1 MRR potentially may be used for Nai+ determination in vivo and Na+ flux measurements; with RRe for animal studies and without RRe for humans.

The application of 23Na double-quantum-filter (DQF) NMR spectroscopy for the study of spinal disc degeneration

Degenerative disc disease is an irreversible process that leads to a loss of mechanical integrity and back pain in millions of people. In this report, (23)Na double-quantum-filtered (DQF) NMR spectroscopy is used to study disc tissues in two stages of degeneration. Initial results indicate that the (23)Na DQF signal may be useful for determining the degree of degeneration. The spectral analysis reveals the presence of sodium environments with different residual quadrupolar couplings and T(2) relaxation times that we attribute to different regions, or compartments, corresponding to different biochemical regions in the tissue. In general it is found that there are compartments with no residual quadrupolar couplings, compartments with moderate couplings (200 to 1000 Hz), and compartments with couplings ranging from 1500 to 3000 Hz. The results indicate that (23)Na DQF NMR spectroscopy provides a probe of the degenerative state of the intervertebral disc tissues, and might hold potential as a novel diagnostic method for detection of disc degeneration.

Detection limit of measurement of pharmaceuticals labeled with short-lived isotopes in HPLC with flow-through gamma-counter

This paper proposes a method for estimating the detection limit, which is defined as 3.3 times the standard deviation (S.D.) of blank measurements under the situations where the repetition of measurement is difficult or impossible because of a short half-life of radioactivity. The FUMI theory, which can estimate an S.D. value without repetition in various instrumental analyses, is adopted and proved here to be available in a radio-HPLC system as well. (99m)Tc-ECD (T(1/2)=360.6 min) that is a lipophilic compound for the diagnosis of regional brain perfusion is taken as an example.

Periodic ab initio calculation of nuclear quadrupole parameters as an assignment tool in solid-state NMR spectroscopy: applications to 23Na NMR spectra of crystalline materials

Periodic ab initio HF calculations using the CRYSTAL code have been used to calculate (23)Na NMR quadrupole parameters for a wide range of crystalline sodium compounds including Na(3)OCl. An approach is developed that can be used routinely as an alternative to point-charge modelling schemes for the assignment of distinct lines in (23)Na NMR spectra to specific crystallographic sodium sites. The calculations are based on standard 3-21 G and 6-21 G molecular basis sets and in each case the same modified basis set for sodium is used for all compounds. The general approach is extendable to other quadrupolar nuclei. For the 3-21 G calculations a 1:1 linear correlation between experimental and calculated values of C(Q)((23)Na) is obtained. The 6-21 G calculations, including the addition of d-polarisation functions, give better accuracy in the calculation of eta((23)Na). The sensitivity of eta((23)Na) to hydrogen atom location is shown to be useful in testing the reported hydrogen-bonded structure of Na(2)HPO(4).

23Na MRI accurately measures fixed charge density in articular cartilage

One of the initiating steps of osteoarthritis is the loss of proteoglycan (PG) molecules from the cartilage matrix. One method for assessing cartilage integrity, therefore, is to measure the PG content or fixed charge density (FCD) of cartilage. This report shows the feasibility of calculating FCD by (23)Na MRI and introduces MRI protocols for human studies, in vivo. (23)Na MRI was used to measure the sodium concentration inside bovine patellar cartilage. The sodium concentration was then converted to FCD (mM) by considering ideal Donnan equilibrium. These FCD measurements were compared to FCD measurements obtained through standard dimethylmethylene blue PG assays. There was a high correlation (slope = 0.89, r(2) = 0.81) between the FCD measurements obtained by (23)Na MRI and those obtained by the PG assays. These methods were then employed in quantifying the FCD of articular cartilage of human volunteers in vivo. Two imaging protocols were compared: one using a birdcage coil, the other using a transmit/receive surface coil. Both methodologies gave similar results, with the average sodium concentration of normal human patellar cartilage ranging from approximately 240 to 260 mM. This corresponds to FCDs of -158 mM to -182 mM.

Nuclear magnetic resonance of sodium-23 linoleate-water. Basis for an alternative interpretation of sodium-23 spectra within cells

The (23)Na spectrum from liquid crystals of sodium linoleate in water has been studied by nuclear magnetic resonance (NMR) techniques. The integrated intensity of the visible central spectral line was 34-39% of the intensity of a reference sample containing an equal quantity and concentration of (23)Na nuclei. Since satellite signals were clearly demonstrable, the effect reflected a nuclear quadrupolar interaction rather than a splitting of the (23)Na into two populations of bound and free nuclei. It is proposed that a similar quadrupolar effect may be the basis for the apparent binding of the (23)Na observed in biological systems.

Activation analysis of soluble and fixed sodium in mammalian hair

Antelope hair was soaked in sodium-22 to simulate external contamination and then systematically washed to remove all traces of the sodium; progress of the wash was followed by gamma-ray spectrometry. Hair was then activated by neutron bombardment which showed sodium still present as sodium-24. It is concluded that a fraction of sodium in hair can be readily washed away with water and that a second fraction is held in the hair in such a manner that extended washing does not remove it. This suggests that sodium in two states may be associated with hair, one as an external contaminant and the other as a more nearly integral part of the hair.

The Effect of Ouabain on the Efflux of Sodium Ions in the Nerve Cords of Two Insect Species (Periplaneta Americana and Carausius Morosus)

1. The intracellular efflux of 22Na from the nerve cord is reduced by the presence of ouabain in the bathing medium. With Periplaneta 10-4M ouabain caused a reduction in the rate constant for sodium efflux from 3.94 x 10-3 sec.-1 to 1.80 x 10-3 sec.-1 and in Carausius from 1.14 x 10-3 sec.-1 to 6.18 x 10-4 sec.-1.

2. Uncoupling of the energy supply to the sodium pump, by the addition of cyanide, did not further reduce the sodium efflux from ouabain-treated axons, suggesting that the greater part of the active extrusion of this cation is effected by a single ouabainsensitive carrier mechanism.

3. The relative insensitivity to ouabain of the insect axons, as compared with squid giant axons, is shown to result from the presence of a rather leaky axon membrane in which the carrier-mediated component forms a much smaller part of the total flux. The concentration gradient of sodium across the insect axon membrane is related to the combined effects of the activity of the sodium pump and the passive permeability of the membrane.