Epicardial Fat Thickness in Patients with Prediabetes and Correlation with Other Cardiovascular Risk Markers

Abstract

Objective Prediabetes is a condition between a normal metabolic state and diabetes mellitus, which includes impaired glucose tolerance (IGT), impaired fasting glucose (IFG), or both. Prediabetes is related with undesirable cardiovascular outcomes. Epicardial fat thickness (EFT) has been correlated with cardiovascular risk factors. We herein aimed to assess EFT in prediabetic patients. Methods We evaluated 64 patients with prediabetes and 30 age-and gender-matched healthy subjects. Demographic and anthropometric characteristics [age, sex, height, weight, body mass index (BMI), and waist circumference (WC)] and laboratory findings [fasting plasma glucose (FPG), postprandial plasma glucose (PPG), hemoglobin A1c (HbA1c), low density lipoprotein (LDL), high density lipoprotein (HDL), and triglycerides (TG)] were assessed. Transthoracic echocardiography was used to evaluate EFT. Results There were no significant differences between the case and control groups in terms of age, gender, height, HDL, WC, systolic and diastolic blood pressure (SBP/DBP), or TG (p>0.05). Body weight, BMI, FPG, LDL, and, in particular, EFT were found to be significantly higher in the case group than control group (p<0.05). When compared with the control group, the median EFT was significantly higher in all prediabetic subgroups (IGT or IFG, p<0.001). However, no statistically significant difference was found between each case subgroup (p=0.795). When groups were adjusted according to age, sex, WC, and BMI with covariance test, the EFT remained increased in the prediabetes subgroups compared to the controls (p<0.001). Conclusion We found the EFT levels to be increased in all subgroups of prediabetic patients regardless of FPG and HbA1c. Furthermore, EFT directly correlated with the patients' BMI and WC.

Circulating SIRT1 inversely correlates with epicardial fat thickness in patients with obesity

“…VAT contains a large number of inflammatory cells and expresses several hormone receptors, and its adipocytes are metabolically active and sensitive to lipolysis. The increased amount of VAT carries, in general, a great prediction of mortality [11] and EF, which substantially mirrors visceral adiposity rather than general obesity, has been correlated with cardiovascular risk factors [8,13,14]. EFT increases in obese patients.…”

“…Specifically, EF thickness (EFT) is associated with premature coronary artery disease [12] and obstructive sleep apnea [13]. EFT increases in prediabetic patients, regardless of fasting plasma glucose and HbA1c [14], and in patients with type 2 diabetes mellitus and obesity [15], representing a diagnostic criterion for patients with metabolic syndrome [16]. It is also inversely correlated with endothelial function [17].…”

Characterization of the inflammatory‐metabolic phenotype of heart failure with a preserved ejection fraction: a hypothesis to explain influence of sex on the evolution and potential treatment of the disease

“…7,130,141 Diabetes is accompanied by epicardial adipose expansion and inflammation 142 ; when diabetes and obesity coexist, each contributes to the volume of epicardial fat. 143 Epicardial adiposity is strongly associated with insulin resistance 144 and changes in ventricular structure and function. 145 The metabolic syndrome and non-alcoholic fatty liver disease are associated with increases in epicardial fat that are accompanied by proportional degrees of diastolic dysfunction and microvascular injury.…”

MRI-based assessment and characterization of epicardial and paracardial fat depots in the context of impaired glucose metabolism and subclinical left-ventricular alterations

“…16,17 In a study by Arpaci et al including 64 prediabetic and 30 healthy subjects, epicardial fat appears to be increased in subjects with prediabetes in comparison to healthy controls. 18 Song et al showed that epicardial fat was increased in subjects with Type 2 diabetes mellitus and obesity. 19 Thus, overall broad evidence is limited so far.…”