Epicardial adipose tissue and insulin resistance in obese subjects
Abstract
CONTEXT: Epicardial adipose tissue has been recently recognized as a source of bioactive molecules as well as free fatty acids, adiponectin, and inflammatory cytokines. Epicardial fat reflects intraabdominal visceral fat, and the echocardiographic assessment of this tissue is an easy and reliable marker of visceral adiposity. OBJECTIVE: In this study we evaluated whether epicardial adipose tissue is related to insulin sensitivity and glucose metabolism in obese subjects. PATIENTS: Thirty obese subjects (20 women and 10 men; mean age, 40.8 +/- 11.5 yr; body mass index, 43 +/- 9.1 kg/m2) were included in this study. No subject was taking drugs or had a history or evidence of metabolic, cardiovascular, respiratory, or hepatic disease. MAIN OUTCOME MEASURES: Each subject underwent a transthoracic echocardiogram to evaluate epicardial adipose tissue thickness, a euglycemic hyperinsulinemic clamp to estimate insulin sensitivity, and an oral glucose tolerance test to evaluate glucose tolerance. RESULTS: The thickness of the epicardial adipose tissue on the right ventricle varied between 4 and 17.4 mm. Echocardiographic epicardial adipose tissue was significantly correlated with whole-body glucose uptake index from the clamp and with all indices of insulin resistance and glucose intolerance measured, except the 120-min plasma glucose level after an oral glucose tolerance test. CONCLUSIONS: Our study showed that the epicardial fat is significantly related to obesity-related insulin resistance. This finding could be of potential interest in clinical practice and research of obesity-related risk stratification.
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In non-diabetic people, impaired fasting glucose or obesity-related reduction of insulin sensitivity are associated with increased epicardial fat.
“In non-diabetic people, impaired fasting glucose, or obesity-related reduction of insulin sensitivity, as assessed by euglycemic hyperinsulinemic clamp and other markers of insulin resistance, are associated with increased epicardial fat [19,55].”
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 [55]
EAT can be easily measured with standard ultrasound and independently reflects intra-abdominal visceral fat and myocardial triglyceride content.
“Epicardial adipose tissue can be easily measured with standard ultrasound and independently reflects intra-abdominal visceral fat and myocardial triglyceride content [7–10].”
From Effects of Semaglutide Versus Dulaglutide on Epicardial Fat Thickness in Subjects with Type 2 Diabetes and Obesity (2020) · cites this paper as [9]
EAT is a modifiable and measurable cardiovascular risk factor that is thicker in subjects with diabetes, owing to its strong correlation with visceral adiposity and insulin resistance.
“EAT has shown to be a modifiable and measurable cardiovascular risk factor that is thicker in subjects with diabetes, owing to its strong correlation with visceral adiposity and insulin resistance [7–9].”
From Effects of Semaglutide Versus Dulaglutide on Epicardial Fat Thickness in Subjects with Type 2 Diabetes and Obesity (2020) · cites this paper as [9]
The amount of epicardial fat parallels the amount of visceral adipose tissue and is correlated with the severity of LVH.
“Iacobellis and colleagues (152, 155) have argued that the amount of epicardial fat parallels the amount of visceral adipose tissue and that the amount of epicardial fat is correlated with the severity of LVH.”
From Cardiac remodeling in obesity (2008) · cites this paper as [152]
Myocardial triglyceride content is significantly increased in obese compared with normal-weight subjects.
“One study used MRI spectroscopy to quantify triglyceride content in human myocardium and found it to be significantly increased in obese compared with normal-weight subjects (152).”
From Cardiac remodeling in obesity (2008) · cites this paper as [152]
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Epicardial adipose tissue feeding and overfeeding the heart
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Epicardial adipose tissue in endocrine and metabolic diseases
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Epicardial fat and its association with cardiovascular risk: A cross-sectional observational study
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Do cardiac and perivascular adipose tissue play a role in atherosclerosis?
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“EAT was independently correlated with insulin resis tance [43-44].”
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How do we measure epicardial adipose tissue thickness by transthoracic echocardiography?
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Relation of Epicardial Fat and Alanine Aminotransferase in Subjects With Increased Visceral Fat
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Increased epicardial fat and plasma leptin in type 1 diabetes independently of obesity
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Echocardiographic epicardial fat thickness is associated with arterial stiffness
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Different “Weight” of Cardiac and General Adiposity in Predicting Left Ventricle Morphology
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- Authors
- Iacobellis, G., & Leonetti, F.
- Affiliations
- Policlinico Umberto I (IT)
- Sapienza University of Rome (IT)
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2005-11
- Volume
- 90
- Issue
- 11
- Pages
- 6300-6302
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W2033442974
- Cited by
- 355
- References
- 18
- Citations by year
- 2026: 8 · 2025: 10 · 2024: 9 · 2023: 18 · 2022: 12 · 2021: 15 · 2020: 21 · 2019: 11 · 2018: 20 · 2017: 14 · 2016: 18 · 2015: 24 · 2014: 30 · 2013: 30 · 2012: 19
- FWCI
- 8.62
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- IRIS Research product catalog (Sapienza University of Rome) (submittedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Disease and Adiposity
- Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- epicardial adipose tissue, insulin resistance, obesity, visceral fat, glucose metabolism, glucose tolerance, echocardiographic measurement, hyperinsulinemic-euglycemic clamp, whole-body glucose uptake
- MeSH terms
- Adipose Tissue, Adult, Echocardiography, Female, Glucose, Humans, Insulin Resistance, Male, Middle Aged, Obesity, Pericardium
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