Key result
High interatrial fat is linked to ~109% higher new-onset diabetes risk.
Why the study?
Visceral adipose tissue is an important indicator for insulin resistance and diabetes beyond overweight/obesity, but the differential effects of region-specific cardiac adiposity on new-onset diabetes are unclear.
Does region-specific cardiac adiposity predict dysglycemia and new-onset diabetes in asymptomatic individuals?
Cohort (n=1,039)
Does region-specific cardiac adiposity predict dysglycemia and new-onset diabetes in asymptomatic individuals?
Hazard Ratio: 2.09 (95% CI 1.38–3.15)
p-value: p=<0.001
Interatrial fat measured by computed tomography is an independent predictor of new-onset diabetes beyond traditional anthropometric measures.
Interatrial fat may identify diabetes risk beyond visceral adiposity; hypothesis-generating and should not yet change practice.
Background Visceral adipose tissue is assumed to be an important indicator for insulin resistance and diabetes beyond overweight/obesity. We hypothesized that region‐specific visceral adipose tissue may regulate differential biological effects for new‐onset diabetes regardless of overall obesity. Methods and Results We quantified various visceral adipose tissue measures, including epicardial adipose tissue, paracardial adipose tissue, interatrial fat, periaortic fat, and thoracic aortic adipose tissue in 1039 consecutive asymptomatic participants who underwent multidetector computed tomography. We explored the associations of visceral adipose tissue with baseline dysglycemic indices and new‐onset diabetes. Epicardial adipose tissue, paracardial adipose tissue, interatrial fat, periaortic fat, and thoracic aortic adipose tissue were differentially and independently associated with dysglycemic indices (fasting glucose, postprandial glucose, HbA1c, and homeostasis model assessment of insulin resistance) beyond anthropometric measures. The superimposition of interatrial fat and thoracic aortic adipose tissue on age, sex, body mass index, and baseline homeostasis model assessment of insulin resistance expanded the likelihood of baseline diabetes (from 67.2 to 86.0 and 64.4 to 70.8, P for ∆ ꭕ 2 : <0.001 and 0.011, respectively). Compared with the first tertile, the highest interatrial fat tertile showed a nearly doubled risk for new‐onset diabetes (hazard ratio, 2.09 [95% CI, 1.38–3.15], P <0.001) after adjusting for Chinese Visceral Adiposity Index. Conclusions Region‐specific visceral adiposity may not perform equally in discriminating baseline dysglycemia or diabetes, and showed differential predictive performance in new‐onset diabetes. Our data suggested that interatrial fat may serve as a potential marker for new‐onset diabetes.
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A 2021 study conducted a cohort in Asymptomatic participants assessed for dysglycemia and new-onset diabetes (n=1,039). Highest interatrial fat tertile vs. First tertile of interatrial fat was evaluated on New-onset diabetes (HR 2.09, 95% CI 1.38-3.15, p=<0.001). The highest interatrial fat tertile was associated with a nearly doubled risk for new-onset diabetes compared with the first tertile (HR 2.09; 95% CI 1.38-3.15; P<0.001).
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