What is the clinical evidence from this study?

Study design: Meta-Analysis. Population: Diabetes mellitus (n=1915). Intervention: Diabetes mellitus vs. Non-diabetes. Primary outcome: Epicardial fat tissue (EFT) (SMD 1.23, 95% CI 0.98, 1.48, p=0.000).

January 10, 2019Open Access

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

Key Result

Patients with diabetes mellitus had significantly higher epicardial fat tissue compared to non-diabetic controls (SMD 1.23).

Study Design

Type

Meta-Analysis (n=1,915)

Structured PICO

Does the presence of diabetes mellitus increase epicardial fat tissue volume or thickness compared to non-diabetic controls?

Population

1,915 participants (1,102 with diabetes mellitus and 813 healthy controls) from 13 observational studies assessing differences in epicardial fat tissue.

Exposure

Presence of Diabetes Mellitus (Type 1 or Type 2)

Comparator

Non-diabetes mellitus healthy control subjects

Outcome

Epicardial fat tissue (EFT) volume or thickness measured by echocardiography, computed tomography (CT), or cardiac magnetic resonance imaging (CMR)surrogate

Epicardial fat tissue is significantly increased in patients with diabetes mellitus compared to non-diabetic controls, suggesting it may serve as a biomarker or therapeutic target for cardiovascular risk in this population.

Main Result

Standardized Mean Difference: 1.23 (95% CI 0.98–1.48)

p-value: p=0.000

Limitations

Small sample size in five included studies
Limited number of studies in some subgroup analyses
Significant heterogeneity among the included studies

Abstract

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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