Association between epicardial adipose tissue, high-sensitivity C-reactive protein and myocardial dysfunction in middle-aged men with suspected metabolic syndrome

Cho, Dong Hyuk; Joo, Hyung Joon; Kim, Mi-Na; Lim, Do Sun; Shim, Wan Joo; Park, Seong‐Mi

doi:10.1186/s12933-018-0735-7

Cited by 49 publications

(49 citation statements)

References 53 publications

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“…Iacobellis et al [21] reported a similar reduction in epicardial fat volume after treatment with liraglutide (up to 1.8 mg/day for 3 and 6 months) and it was recently reported that epicardial adipose tissue expresses the GLP-1 receptor [31]. This is of clinical importance, since it was recently shown that inflammatory activity of epicardial adipose tissue volume might induce myocardial remodelling and dysfunction [32]. In the current study, a reduction of either epicardial or…”

Section: Discussionsupporting

confidence: 76%

A double-blind, placebo-controlled, randomised trial to assess the effect of liraglutide on ectopic fat accumulation in South Asian type 2 diabetes patients

Eyk

Paiman

Bizino

et al. 2019

Cardiovasc Diabetol

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Background South Asians have a high risk to develop type 2 diabetes, which may be related to substantial ectopic fat deposition. Since glucagon-like peptide-1 analogues can reduce ectopic fat accumulation, the aim of the present study was to assess the effect of treatment with liraglutide for 26 weeks on ectopic fat deposition and HbA1c in South Asian patients with type 2 diabetes. Methods In a placebo-controlled trial, 47 South Asian patients with type 2 diabetes were randomly assigned to treatment with liraglutide (1.8 mg/day) or placebo added to standard care. At baseline and after 26 weeks of treatment we assessed abdominal subcutaneous, visceral, epicardial and paracardial adipose tissue volume using MRI. Furthermore, myocardial and hepatic triglyceride content were examined with proton magnetic resonance spectroscopy. Results In the intention-to-treat analysis, liraglutide decreased body weight compared to placebo (− 3.9 ± 3.6 kg vs − 0.6 ± 2.2 kg; mean change from baseline (liraglutide vs placebo): − 3.5 kg; 95% CI [− 5.3, − 1.8]) without significant effects on the different adipose tissue compartments. HbA1c was decreased in both groups without between group differences. In the per-protocol analysis, liraglutide did decrease visceral adipose tissue volume compared to placebo (− 23 ± 27 cm 2 vs − 2 ± 17 cm 2 ; mean change from baseline (liraglutide vs placebo): − 17 cm 2 ; 95% CI [− 32, − 3]). Furthermore, HbA1c was decreased by liraglutide compared to placebo (− 1.0 ± 0.8% (− 10.5 ± 9.1 mmol/mol)) vs (− 0.6 ± 0.8% (− 6.1 ± 8.8 mmol/mol)), with a between group difference (mean change from baseline (liraglutide vs placebo): − 0.6% (− 6.5 mmol/mol); 95% CI [− 1.1, − 0.1 (− 11.5, − 1.5)]). Interestingly, the decrease of visceral adipose tissue volume was associated with the reduction of HbA1c (β: 0.165 mmol/mol (0.015%) per 1 cm 2 decrease of visceral adipose tissue volume; 95% CI [0.062, 0.267 (0.006, 0.024%)]). Conclusions While the intention-to-treat analysis did not show effects of liraglutide on ectopic fat and HbA1c, per-protocol analysis showed that liraglutide decreases visceral adipose tissue volume, which was associated with improved glycaemic control in South Asians. Trial registration NCT02660047 (clinicaltrials.gov). Registered 21 January 2016

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Section: Discussionsupporting

confidence: 76%

A double-blind, placebo-controlled, randomised trial to assess the effect of liraglutide on ectopic fat accumulation in South Asian type 2 diabetes patients

Eyk

Paiman

Bizino

et al. 2019

Cardiovasc Diabetol

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“…Previous studies have suggested that measurements of EFT are a substitute for visceral fat [8,9] EFT can secrete inflammatory factors, such as TNF-alpha, IL-6, adipocytokines, and leptin, via paracrine or endocrine activities [9,10] to locally regulate the myocardium and coronary artery function and regulate lipid and energy homeostasis in vivo. EFT has the ability to release and uptake free fatty acids and to affect low glucose utilization, which plays an important role in metabolic syndrome and coronary artery disease [11][12][13][14][15][16]. EFT can be measured by echocardiography, cardiac magnetic resonance imaging, and computed tomography (CT) [17].…”

Section: Introductionmentioning

confidence: 99%

Epicardial fat tissue in patients with diabetes mellitus: a systematic review and meta-analysis

Liu

et al. 2019

Cardiovasc Diabetol

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Background: Epicardial fat tissue (EFT) is the visceral fat distributed along the coronary arteries between the pericardium and the myocardium. Increases in EFT are closely related to the occurrence of diabetes mellitus (DM) and cardiovascular disease. To further understand the link between EFT and DM, we conducted a meta-analysis of the relevant literature. Methods: We systematically searched electronic databases for studies on EFT performed in DM patients and published up to 30 September 2018. We included data on EFT in a DM patient group and a non-DM control group. We then assessed the effect of DM on EFT by meta-analysis and trial sequential analysis (TSA). All statistical analyses were performed using Stata 12.0 and TSA software. Results: A total of 13 studies (n = 1102 patients) were included in the final analysis. Compared with the control group, DM patients had significantly higher EFT (SMD: 1.23; 95% CI 0.98, 1.48; P = 0.000; TSA-adjusted 95% CI 0.91, 2.13; P < 0.0001). The TSA indicated that the available samples were sufficient and confirmed that firm evidence was reached. According to the regression analysis and subgroup analyses, DM typing, EFT ultrasound measurements, total cholesterol (TC) and triglyceride (TG) levels were confounding factors that significantly affected our results. Conclusions: Our meta-analysis suggests that the amount of EFT is significantly higher in DM patients than in non-DM patients.

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“…The present study results, generated from a large sample, also strongly support the regional effects of PAT on LV systolic function, independent of general obesity measures and gender (data not shown). However, one study found that the association of EAT with impaired LV systolic function assessed by strain and TDI techniques was observed only in men [28].…”

Section: Discussionmentioning

confidence: 99%

Association of Pericardial Adipose Tissue With Left Ventricular Structure and Function: A Region-specific Effect?

Kim

Lee

et al. 2020

Preprint

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Background: The independent role of pericardial adipose tissue (PAT) as an ectopic fat associated with cardiovascular disease (CVD) remains controversial. This study aimed to determine whether PAT is associated with left ventricular (LV) structure and function independent of other markers of general obesity.Methods: We studied 2,471 participants (50.9% women) without known CVD from the Korean Genome Epidemiology Study, who underwent 2D-echocardiography with tissue Doppler imaging (TDI) and computed tomography measurement for PAT.Results: Study participants with more PAT were more likely to be men and had higher cardiometabolic indices, including blood pressure, glucose, and cholesterol levels (all P <0.001). Greater pericardial fat levels across quartiles of PAT were associated with increased LV mass index and left atrial volume index (all P <0.001) and decreased systolic (P = 0.015) and early diastolic (P <0.001) TDI velocities, except for LV ejection fraction. These associations remained after a multivariable-adjusted model for traditional CV risk factors and persisted after additional adjustment for general adiposity measures, such as waist circumference and body mass index. PAT was the only obesity index independently associated with systolic TDI velocity (P <0.001).Conclusions: PAT was associated with subclinical LV structural and functional changes, and these associations were independent of and stronger than with general and abdominal obesity measures.

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Association between epicardial adipose tissue, high-sensitivity C-reactive protein and myocardial dysfunction in middle-aged men with suspected metabolic syndrome

Cited by 49 publications

References 53 publications

A double-blind, placebo-controlled, randomised trial to assess the effect of liraglutide on ectopic fat accumulation in South Asian type 2 diabetes patients

A double-blind, placebo-controlled, randomised trial to assess the effect of liraglutide on ectopic fat accumulation in South Asian type 2 diabetes patients

Epicardial fat tissue in patients with diabetes mellitus: a systematic review and meta-analysis

Association of Pericardial Adipose Tissue With Left Ventricular Structure and Function: A Region-specific Effect?

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