Key result
Pre-diabetes and type-2 diabetes are associated with increased epicardial adipose tissue volume and reduced attenuation, though these associations are largely dependent on co-variation with visceral adipose tissue.
Why the study?
Data on epicardial adipose tissue volume and attenuation patterns in pre-diabetes are scarce, and any independent role of these markers in pre-diabetes and T2D development remains to be proven.
Are pre-diabetes and type 2 diabetes associated with changes in epicardial adipose tissue volume and attenuation compared to normal glucose tolerance?
Cross-Sectional (n=1,948)
Are pre-diabetes and type 2 diabetes associated with changes in epicardial adipose tissue volume and attenuation compared to normal glucose tolerance?
Absolute Event Rate: 146.6% vs 104.9%
p-value: p=<0.01
While epicardial adipose tissue volume increases and attenuation decreases in pre-diabetes and T2D, these changes are heavily confounded by visceral adiposity, complicating their independent role as cardiovascular risk markers.
EAT changes in pre-diabetes or T2D should not yet inform risk stratification; leaves open independent prognostic value beyond visceral adiposity.
The volume of epicardial adipose tissue (EATV) is increased in type-2 diabetes (T2D), while its attenuation (EATA) appears to be decreased. Similar patterns have been suggested in pre-diabetes, but data is scarce. In both pre-diabetes and T2D, any independent role of EATV and EATA in disease development remains to be proven, a task complicated by their substantial co-variation with other anthropometrics, e.g. BMI, waist circumference, and abdominal visceral adipose tissue (VAT). EATV and EATA was quantified in computed tomography (CT) images in a population study (n = 1948) using an automatic technique. Data was available on BMI, waist circumference, abdominal visceral adipose tissue (VAT) area, insulin resistance (IR) and glucose tolerance, the latter ranging from normal (NGT), over pre-diabetes (impaired fasting glucose [IFG, n = 414] impaired glucose tolerance [IGT, n = 321] and their combination [CGI, n = 128]), to T2D. EATV was increased in pre-diabetes, T2D and IR in univariable analyses and when adjusting for BMI, however not when adjusting for waist or VAT. EATA was reduced in pre-diabetes, T2D and IR in univariable analyses and when adjusting for BMI and waist, however not when adjusting for VAT. Adjustment for other co-variates had little influence on the results. In conclusion, EATV is increased and EATA reduced in pre-diabetes, T2D and IR, however, significant co-variation with other anthropometrics, especially VAT, obscures their function in disease development. The current results do not exclude a pathophysiological role of epicardial fat, but future studies need to adjust for anthropometrics, or focus on the microenvironment within the pericardial sac.
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Molnár et al. (2023) conducted a cross-sectional in Pre-diabetes and Type-2 Diabetes (n=1,948). Pre-diabetes and Type-2 diabetes vs. Normal glucose tolerance (NGT) was evaluated on Median epicardial adipose tissue volume (EATV) in ml (p=<0.01). Pre-diabetes and type-2 diabetes are associated with increased epicardial adipose tissue volume and reduced attenuation, though these associations are largely dependent on co-variation with visceral adipose tissue.
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