Development of an Early-Stage Diabetic Cardiomyopathy Rat Model with Early Myocardial Remodeling Induced by HFHF Diet and Low-Dose Streptozotocin
DOI:
https://doi.org/10.30701/ijc.2194Keywords:
Diabetic Cardiomyopathy, High-Fat High-Fructose Diet, StreptozotocinAbstract
Background: Diabetic Cardiomyopathy (DCM) is defined as structural and functional abnormalities of the myocardium occurring in individuals with Diabetes Mellitus (DM) in the absence of other conventional cardiovascular risk factors. Establishing a reliable early-stage DCM model is essential for mechanistic studies and therapeutic evaluation. This study aimed to characterize an early-stage DCM model in male Sprague–Dawley rats using a High-Fat High-Fructose (HFHF) diet combined with low-dose Streptozotocin (STZ).
Methods: Twelve male Sprague–Dawley rats (7–8 weeks, 200–250 g) were randomly assigned to three groups (n=4/group): control, HFHF + STZ 25 mg/kg, and HFHF + STZ 40 mg/kg. Rats received an HFHF diet for 12 weeks, followed by intraperitoneal STZ induction. Fasting blood glucose, lipid profile, cardiac echocardiography, serum N-Terminal pro-B-type Natriuretic Peptide (NT-proBNP), and myocardial histopathology were assessed. Data were analyzed using ANOVA or Kruskal–Wallis as appropriate.
Results: Both STZ doses induced persistent hyperglycemia without significant body-weight changes, consistent with a DCM metabolic phenotype. NT-proBNP levels were significantly elevated in both STZ groups compared with controls (p<0.05), indicating early myocardial stress despite preserved systolic and diastolic function on echocardiography. Histopathological evaluation showed increased inflammatory cell infiltration and progressive fibrosis in the HFHF+STZ groups, with a graded pattern across STZ doses.
Conclusions: The combination of an HFHF diet and low-dose STZ reproduced an early-stage DCM model characterized by persistent hyperglycemia, elevated NT-proBNP, and early myocardial remodeling while cardiac function remains preserved. This model reflects early DCM and is suitable for mechanistic studies and for testing therapies aimed at preventing progression to advanced myocardial dysfunction.
Downloads
References
1. Diagnosis and Classification of Diabetes: Standards of Care in Diabetes-2024. Diabetes Care. 2024;47:S20-S42.
2. Five questions on the IDF Diabetes Atlas. Diabetes Res Clin Pract. 2013;102:147-148.
3. RI KK. Hasil Riset Kesehatan Dasar (Riskesdas) 2018.; 2018.
4. Fowler MJ. Microvascular and Macrovascular Complications of Diabetes. Clin Diabetes. 2011;29:116-122.
5. Pan Y, Wang Y, Zhao Y, Peng K, Li W, Wang Y, Zhang J, Zhou S, Liu Q, Li X, Cai L, Liang G. Inhibition of JNK phosphorylation by a novel curcumin analog prevents high glucose-induced inflammation and apoptosis in cardiomyocytes and the development of diabetic cardiomyopathy. Diabetes. 2014;63:3497-3511.
6. Einarson TR, Acs A, Ludwig C, Panton UH. Prevalence of cardiovascular disease in type 2 diabetes: a systematic literature review of scientific evidence from across the world in 2007-2017. Cardiovasc Diabetol. 2018;17.
7. Rawshani A, Rawshani A, Franzén S, Sattar N, Eliasson B, Svensson A-M, Zethelius B, Miftaraj M, McGuire DK, Rosengren A, Gudbjörnsdottir S. Risk Factors, Mortality, and Cardiovascular Outcomes in Patients with Type 2 Diabetes. N Engl J Med. 2018;379:633-644.
8. Gulsin GS, Athithan L, McCann GP. Diabetic cardiomyopathy: prevalence, determinants and potential treatments. Ther Adv Endocrinol Metab. 2019;10:2042018819834869.
9. National Diabetes Audit 2015-16 Publication Background.
10. Jia G, Hill MA, Sowers JR. Diabetic cardiomyopathy: an update of mechanisms contributing to this clinical entity. Circ Res. 2018;122:624.
11. Zhao X, Liu S, Wang X, Chen Y, Pang P, Yang Q, Lin J, Deng S, Wu S, Fan G, Wang B. Diabetic cardiomyopathy: Clinical phenotype and practice. Front Endocrinol (Lausanne). 2022;13.
12. Avagimyan A, Fogacci F, Pogosova N, Kakrurskiy L, Kogan E, Urazova O, et al. Diabetic Cardiomyopathy: 2023 Update by the International Multidisciplinary Board of Experts. Curr Probl Cardiol. 2024;49.
13. Huo JL, Feng Q, Pan S, Fu WJ, Liu Z, Liu Z. Diabetic cardiomyopathy: Early diagnostic biomarkers, pathogenetic mechanisms, and therapeutic interventions. Cell death Discov. 2023;9.
14. Giri B, Dey S, Das T, Sarkar M, Banerjee J, Dash SK. Chronic hyperglycemia mediated physiological alteration and metabolic distortion leads to organ dysfunction, infection, cancer progression and other pathophysiological consequences: An update on glucose toxicity. Biomed Pharmacother. 2018;107:306-328.
15. Mamuaja MN, Maksum IP, Herlina T, Rumampuk RY. Antidiabetic activities of sesewanua (Clerodendrum squamatum Vahl.) leaves and flavonoids profiling of the bioactive extract. J Plant Interact. 2025;20.
16. Marino F, Salerno N, Scalise M, Salerno L, Torella A, Molinaro C, et al. Streptozotocin-Induced Type 1 and 2 Diabetes Mellitus Mouse Models Show Different Functional, Cellular and Molecular Patterns of Diabetic Cardiomyopathy. Int J Mol Sci. 2023;24.
17. Lee W-S, Kim J. Application of Animal Models in Diabetic Cardiomyopathy. Diabetes Metab J. 2021;45:129-145.
18. Srinivasan K, Ramarao P. Animal models in type 2 diabetes research: An overview. Indian J Med Res. 2007;125.
19. Bugger H, Abel ED. Molecular mechanisms of diabetic cardiomyopathy. Diabetologia. 2014;57:660.
20. Wen W, Cao Y, Chen P, Li J, Li W, Huang G, Zheng H, Zhu X, Zhang H, Chen Y, Huang X, Hu Y, Huang Y. A reliable strategy for establishment of an animal model of diabetic cardiomyopathy: Induction by a high-fat diet combined with single or multiple injections of low-dose streptozotocin. Life Sci. 2024;358:123161.
21. Fuentes-Antras J, Picatoste B, Gomez-Hernandez A, Egido J, Tunon J, Lorenzo O. Updating experimental models of diabetic cardiomyopathy. J Diabetes Res. 2015;2015.
22. Srinivasan K, Ramarao P. Animal models in type 2 diabetes research: an overview. Indian J Med Res. 2007;125:451-472.
23. Bugger H, Abel ED. Molecular mechanisms of diabetic cardiomyopathy. Diabetologia. 2014;57:660-671.
24. Lorenzo-Almorós A, Tuñón J, Orejas M, Cortés M, Egido J, Lorenzo Ó. Diagnostic approaches for diabetic cardiomyopathy. Cardiovasc Diabetol. 2017;16:28.
25. Engle SK, Watson DE. Natriuretic Peptides as Cardiovascular Safety Biomarkers in Rats: Comparison With Blood Pressure, Heart Rate, and Heart Weight. Toxicol Sci. 2016;149:458-472.
26. Karuna N, Kerrigan L, Edgar K, Tonry C, Grieve D, Watson C. Signature of diabetic cardiomyopathy progression using high-fat diet and streptozotocin mouse model: from subclinical to clinical with three-hit mouse model. Eur Heart J. 2024;45.
27. Cohen CD, De Blasio MJ, Lee MKS, Farrugia GE, Prakoso D, Krstevski C, Deo M, Donner DG, Kiriazis H, Flynn MC, Gaynor TL, Murphy AJ, Drummond GR, Pinto AR, Ritchie RH. Diastolic dysfunction in a pre-clinical model of diabetes is associated with changes in the cardiac non-myocyte cellular composition. Cardiovasc Diabetol. 2021;20.
28. Kayama Y, Raaz U, Jagger A, Adam M, Schellinger IN, Sakamoto M, Suzuki H, Toyama K, Spin JM, Tsao PS. Diabetic Cardiovascular Disease Induced by Oxidative Stress. Int J Mol Sci. 2015;16:25234-25263.
29. Isfort M, Stevens SCW, Schaffer S, Jong CJ, Wold LE. Metabolic dysfunction in diabetic cardiomyopathy. Heart Fail Rev. 2014;19:35-48.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Indonesian Journal of Cardiology

This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).








