Key result
T2DM in postmenopausal women is linked to higher EAT volume and impaired myocardial microcirculation.
Why the study?
T2DM often occurs conjunctly with menopausal transition, and epicardial adipose tissue unfavorably impacts the myocardium and coronary arteries during metabolic disorders.
Does Type 2 Diabetes Mellitus impact epicardial adipose tissue volume and myocardial microvascular function in postmenopausal women?
Does Type 2 Diabetes Mellitus impact epicardial adipose tissue volume and myocardial microvascular function in postmenopausal women?
In postmenopausal women, Type 2 diabetes is associated with increased epicardial adipose tissue volume and impaired myocardial microcirculation, with EAT volume independently correlating with microvascular dysfunction.
May signal microvascular risk in postmenopausal T2DM; hypothesis-generating and leaves open causal or therapeutic implications.
Background Type 2 diabetes mellitus (T2DM) often occurs conjunctly with the menopausal transition in female patients. In addition, epicardial adipose tissue (EAT) has an unfavorable impact on the myocardium and coronary arteries under the influence of metabolic disorders. Purpose To investigate the impact of T2DM on EAT and myocardial microvascular function in postmenopausal women. Study Type Retrospective. Population One‐hundred sixty‐one postmenopausal women divided into three groups: newly diagnosed (≤5 years) T2DM ( n = 56, 58.6 ± 7.7 years), long‐term (>5 years) T2DM ( n = 57, 61.9 ± 7.9 years), and healthy controls ( n = 48, 59.4 ± 7.4 years). Field Strength/Sequence 3.0 T; balanced steady‐state free precession and inversion recovery prepared echo‐planar sequences. Assessment EAT volume was quantified by delineating the epicardial border and the visceral layer of pericardium on the short‐axis cine stacks. Perfusion parameters including upslope, maximum signal intensity (MaxSI) and time to maximum signal intensity (TTM) were derived from the first‐pass perfusion signal intensity–time curves. Statistical Tests One‐way analysis of variance, Pearson's and Spearman correlation, and multivariable linear regression. Two‐sided P < 0.05 was considered statistically significant. Results EAT volume was significantly increased in diabetic postmenopausal women compared to the controls (48.4 ± 13.4 mL/m 2 [newly diagnosed T2DM] vs. 58.4 ± 17.3 mL/m 2 [long‐term T2DM] vs. 35.8 ± 12.3 mL/m 2 [controls]). Regarding perfusion parameters, upslope and MaxSI were significantly reduced (2.6 ± 1.0 [newly diagnosed T2DM] vs. 2.1 ± 0.8 [long‐term T2DM] vs. 3.6 ± 1.3 [controls]; and 21.4 ± 6.9 [newly diagnosed T2DM] vs. 18.7 ± 6.4 [long‐term T2DM] vs. 28.4 ± 8.6 [controls]), whereas TTM was significantly increased in the T2DM groups compared to the control group (23.6 ± 8.7 [newly diagnosed T2DM] vs. 27.1 ± 9.4 [long‐term T2DM] vs. 21.4 ± 6.0 [controls]). Multivariable analysis (adjusted coefficient of determination [ R 2 ] = 0.489) showed that EAT volume ( β = −0.610) and menopausal age ( β = 0.433) were independently correlated with decreased perfusion upslope. Data Conclusion Diabetic postmenopausal women had significantly higher EAT volume and more impaired microcirculation compared to the controls. Increased EAT volume and earlier menopausal age were independently associated with microvascular dysfunction in these patients.
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Huang et al. (2022) studied this question. Postmenopausal women with newly diagnosed and long-term T2DM had significantly higher EAT volume and impaired myocardial microcirculation compared to healthy controls.
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