Epicardial adipose tissue volume and diabetic retinopathy

Introduction We explored the association between epicardial adipose tissue (EAT) volume and diabetic retinopathy. Methods We used clinical data from a monocentric mixed retrospective and prospective observational study of 1093 individuals living with diabetes who had a computed tomography (CT) scan in order to calculate their coronary artery calcium (CAC) score. This scan was also used to compute EAT volume. For the present study, only persons whose diabetic retinopathy status was known (i.e., yes/no) were included. Results We included 1037 individuals living with diabetes (type 2 79.1%, type 1 14.8%, other types 6.2%) for 14.6 ± 9.9 years. Mean body mass index was 29.4 ± 5.9 kg/m², HbA1c was 8.7 ± 2.2%, 38.2% had diabetic retinopathy, and EAT volume was 93 ± 40 cm 3 . Diabetic retinopathy was positively associated with North African ethnicity, type 1 diabetes, longer diabetes duration, higher HbA1c levels, and more hypertension and diabetes-related complications (nephropathy, neuropathy, macroangiopathy and a high CAC score). EAT volume was lower in patients with diabetic retinopathy than in those without (87 ± 37 vs 97 ± 42 cm 3 , P < 0.0001), independently of confounders (per 10cm 3 increase: odds ratio 0.89 [95% confidence interval 0.84;0.93], P < 0.0001). Conclusion We found an unexpected negative association between the volume of EAT—a proinflammatory tissue—and diabetic retinopathy prevalence. This finding warrants further mechanistic investigation.