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Increased epicardial adipose tissue (EAT) volume in type 2 diabetes mellitus and association with metabolic syndrome and severity of coronary atherosclerosis
Abstract
OBJECTIVE: Epicardial adipose tissue (EAT) is a part of visceral fat deposited around the heart between the pericardium and myocardium along the distribution of coronary arteries. EAT thickness is reported to be associated with coronary atherosclerosis; however, no study has measured EAT volume in patients with type 2 diabetes or investigate its association with coronary artery disease. DESIGN: A hospital-based case control study. PATIENTS: A total of 49 patients with type 2 diabetes mellitus (T2DM) and 78 nondiabetic controls were studied. MEASUREMENTS: Cardiac multislice computed tomography was used to measure EAT volume, Gensini score, coronary artery calcium score and, coronary lesions. The relationships between EAT volume, markers of coronary atherosclerosis and anthropometric and biochemical parameters of metabolic syndrome (MetS) were investigated. RESULTS: EAT volume was significantly higher in patients with T2DM than in nondiabetic subjects (166.1 +/- 60.6 cm(3) vs. 123.4 +/- 41.8 cm(3), P < 0.0001). Logistic regression analysis revealed independent and significant associations between EAT and diabetic status. EAT volume was significantly associated with components of MetS (BMI, waist circumference, fasting serum glucose, total cholesterol, HDL-cholesterol, and triglycerides levels), Gensini score, coronary lesions, coronary disease and coronary calcium scores. Univariate, multivariate and trend analyses confirmed that EAT volume was associated with MetS component clustering and the coronary atherosclerosis index. CONCLUSIONS: The analytical results indicate that EAT volume is increased in T2DM patients and is associated with unfavourable components of MetS and coronary atherosclerosis. The close anatomical relationship between EAT and the coronary arteries, combined with other evidence indicating that EAT is a biologically active adipokine-secreting tissue, suggest that EAT participates in the pathogenesis of diabetic coronary atherosclerosis.
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“On the other hand, diabetic patients often exhibit an abnormally expanded EAT, usually in association with obesity and metabolic syndrome in both T2DM and T1DM [19,20,21,22].”
From Dysregulated epicardial adipose tissue as a risk factor and potential therapeutic target of heart failure with preserved ejection fraction in diabetes (2022) · cites this paper as [21]
In the citing paper
“Various studies indicate that an enlarged EAT mass in T2DM is associated with obesity and metabolic syndrome and its components [21,56].”
From Dysregulated epicardial adipose tissue as a risk factor and potential therapeutic target of heart failure with preserved ejection fraction in diabetes (2022) · cites this paper as [21]
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Echocardiographic Epicardial Adipose Tissue Thickness as a Marker of Insulin Resistance
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Clinical aspects of epicardial fat deposition
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Evaluation of Chemerin in Acute Coronary Syndrome and its Role in Cardiodiabetics
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Epikardiales Fett: Bildgebung und Bedeutung für Erkrankungen des kardiovaskulären Systems
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Usefulness of Screening Left Atrioventricular Groove Epicardial Adipose Tissue Thickness
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Tejido adiposo epicárdico: su relación con enfermedades cardiovasculares
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Metadata
- Authors
- Wang, C., Hsu, H., Hung, W., Yu, T., Chen, Y., Chiu, C., Lu, L., Chung, F., Shin, S., & Lee, Y.
- Affiliations
- E-Da Hospital (TW)
- Cathay General Hospital (TW)
- Kaohsiung Medical University (TW)
- Corresponding author
- Lee, Yau‐Jiunn
- Venue
- Clinical Endocrinology
- Publisher
- Wiley
- Published
- 2009-05-13
- Volume
- 70
- Issue
- 6
- Pages
- 876-882
- ISSN
- 0300-0664 (ISSN-L)
- 1365-2265
- OpenAlex
- W2053427294
- Cited by
- 229
- References
- 31
- Citations by year
- 2026: 7 · 2025: 9 · 2024: 7 · 2023: 11 · 2022: 8 · 2021: 15 · 2020: 9 · 2019: 13 · 2018: 10 · 2017: 13 · 2016: 14 · 2015: 19 · 2014: 18 · 2013: 24 · 2012: 19
- FWCI
- 8.03
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Endocrinology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Science Council
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Disease and Adiposity
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Cardiac Imaging and Diagnostics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adipokines, Inflammation, and Metabolic Diseases
- Keywords
- epicardial adipose tissue, type 2 diabetes, metabolic syndrome, coronary artery disease, EAT volume, coronary artery calcium score, Gensini score, visceral fat, adipokines, coronary artery lesions
- MeSH terms
- Adipose Tissue, Coronary Artery Disease, Diabetes Mellitus, Type 2, Female, Humans, Male, Middle Aged, Pericardium, Severity of Illness Index, Tomography, X-Ray Computed, Case-Control Studies, Metabolic Syndrome
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