scholarly journals Epicardial adipose tissue volume and coronary calcification among people living with diabetes: a cross-sectional study

2020 ◽  
Author(s):  
Emmanuel Cosson ◽  
Minh Tuan Nguyen ◽  
Imen Rezgani ◽  
Sopio Tatulashvili ◽  
Meriem Sal ◽  
...  
Keyword(s):  
Adipose Tissue ◽  
Epicardial Adipose Tissue ◽  
Multivariable Analysis ◽  
Hdl Cholesterol ◽  
Macrovascular Disease ◽  
Coronary Calcification ◽  
Lipid Lowering ◽  
Smoking History ◽  
Cross Sectional ◽  
Patients With Diabetes

Abstract Background Epicardial adipose tissue (EAT) has anatomic and functional proximity to the heart and is considered a novel diagnostic marker and therapeutic target in cardiometabolic diseases. The aim of this study was to evaluate whether EAT volume was associated with coronary artery calcification (CAC) in people living with diabetes, independently of confounding factors.Methods We included all consecutive patients with diabetes whose EAT volume and CAC score were measured using computed tomography between January 1, 2019 and September 30, 2020 in the Department of Diabetology-Endocrinology-Nutrition at Avicenne Hospital, France. Determinants of EAT volume and a CAC score ≥ 100 Agatston units (AU) were evaluated.Results The study population comprised 409 patients (218 men). Mean (± standard deviation) age was 57 ± 12 years, and 318, 56 and 35, had type 2 (T2D), type 1 (T1D), or another type of diabetes, respectively. Mean body mass index (BMI) was 29 ± 6 kg/m², mean AET volume 93 ± 38 cm3. EAT volume was positively correlated with age, BMI, pack-year smoking history and triglyceridaemia, but negatively correlated with HDL-cholesterol level. Furthermore, it was lower in people with retinopathy, but higher in men, in Caucasian people, in patients on antihypertensive and lipid-lowering medication, in people with nephropathy, and finally in individuals with a CAC ≥ 100 AU (CAC < 100 vs CAC ≥ 100: 89 ± 35 vs 109 ± 41 cm3, respectively, p < 0.05). In addition to EAT volume, other determinants of CAC ≥ 100 AU (n = 89, 22%) were age, T2D, ethnicity, antihypertensive and lipid-lowering medication, cumulative tobacco consumption, retinopathy, macular edema and macrovascular disease. Multivariable analysis considering all these determinants as well as gender and BMI, showed that EAT volume was independently associated with CAC ≥ 100 AU (per 10 cm3 increase: OR 1.11 [1.02–1.20]).Conclusions EAT volume was independently associated with CAC. As it may play a role in coronary atherosclerosis in patients with diabetes, reducing EAT volume through physical exercise, improved diet and pharmaceutical interventions may improve future cardiovascular risk outcomes in this population.

scholarly journals Epicardial adipose tissue volume and coronary calcification among people living with diabetes: a cross-sectional study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Emmanuel Cosson ◽  
Minh Tuan Nguyen ◽  
Imen Rezgani ◽  
Sopio Tatulashvili ◽  
Meriem Sal ◽  
...  
Keyword(s):  
Adipose Tissue ◽  
Epicardial Adipose Tissue ◽  
Multivariable Analysis ◽  
Hdl Cholesterol ◽  
Macrovascular Disease ◽  
Coronary Calcification ◽  
Lipid Lowering ◽  
Smoking History ◽  
Cross Sectional ◽  
Patients With Diabetes

Abstract Background Epicardial adipose tissue (EAT) has anatomic and functional proximity to the heart and is considered a novel diagnostic marker and therapeutic target in cardiometabolic diseases. The aim of this study was to evaluate whether EAT volume was associated with coronary artery calcification (CAC) in people living with diabetes, independently of confounding factors. Methods We included all consecutive patients with diabetes whose EAT volume and CAC score were measured using computed tomography between January 1, 2019 and September 30, 2020 in the Department of Diabetology-Endocrinology-Nutrition at Avicenne Hospital, France. Determinants of EAT volume and a CAC score ≥ 100 Agatston units (AU) were evaluated. Results The study population comprised 409 patients (218 men). Mean (± standard deviation) age was 57 ± 12 years, and 318, 56 and 35 had type 2 (T2D), type 1 (T1D), or another type of diabetes, respectively. Mean body mass index (BMI) was 29 ± 6 kg/m2, mean AET volume 93 ± 38 cm3. EAT volume was positively correlated with age, BMI, pack-year smoking history and triglyceridaemia, but negatively correlated with HDL-cholesterol level. Furthermore, it was lower in people with retinopathy, but higher in men, in Caucasian people, in patients on antihypertensive and lipid-lowering medication, in people with nephropathy, and finally in individuals with a CAC ≥ 100 AU (CAC < 100 vs CAC ≥ 100: 89 ± 35 vs 109 ± 41 cm3, respectively, p < 0.05). In addition to EAT volume, other determinants of CAC ≥ 100 AU (n = 89, 22%) were age, T2D, ethnicity, antihypertensive and lipid-lowering medication, cumulative tobacco consumption, retinopathy, macular edema and macrovascular disease. Multivariable analysis considering all these determinants as well as gender and BMI showed that EAT volume was independently associated with CAC ≥ 100 AU (per 10 cm3 increase: OR 1.11 [1.02–1.20]). Conclusions EAT volume was independently associated with CAC. As it may play a role in coronary atherosclerosis in patients with diabetes, reducing EAT volume through physical exercise, improved diet and pharmaceutical interventions may improve future cardiovascular risk outcomes in this population.

scholarly journals Epicardial adipose tissue volume and coronary calcification among people living with diabetes: a cross-sectional study

2021 ◽  
Author(s):  
Emmanuel Cosson ◽  
Minh Tuan Nguyen ◽  
Imen Rezgani ◽  
Sopio Tatulashvili ◽  
Meriem Sal ◽  
...  
Keyword(s):  
Adipose Tissue ◽  
Epicardial Adipose Tissue ◽  
Multivariable Analysis ◽  
Hdl Cholesterol ◽  
Macrovascular Disease ◽  
Coronary Calcification ◽  
Lipid Lowering ◽  
Smoking History ◽  
Cross Sectional ◽  
Patients With Diabetes

Abstract Background: Epicardial adipose tissue (EAT) has anatomic and functional proximity to the heart and is considered a novel diagnostic marker and therapeutic target in cardiometabolic diseases. The aim of this study was to evaluate whether EAT volume was associated with coronary artery calcification (CAC) in people living with diabetes, independently of confounding factors.Methods: We included all consecutive patients with diabetes whose EAT volume and CAC score were measured using computed tomography between January 1, 2019 and September 30, 2020 in the Department of Diabetology-Endocrinology-Nutrition at Avicenne Hospital, France. Determinants of EAT volume and a CAC score ≥ 100 Agatston units (AU) were evaluated. Results: The study population comprised 409 patients (218 men). Mean (± standard deviation) age was 57±12 years, and 318, 56 and 35 had type 2 (T2D), type 1 (T1D), or another type of diabetes, respectively. Mean body mass index (BMI) was 29±6 kg/m², mean AET volume 93±38 cm3. EAT volume was positively correlated with age, BMI, pack-year smoking history and triglyceridaemia, but negatively correlated with HDL-cholesterol level. Furthermore, it was lower in people with retinopathy, but higher in men, in Caucasian people, in patients on antihypertensive and lipid-lowering medication, in people with nephropathy, and finally in individuals with a CAC ≥ 100 AU (CAC < 100 vs CAC ≥ 100: 89±35 vs 109±41 cm3, respectively, p<0.05). In addition to EAT volume, other determinants of CAC ≥ 100 AU (n=89, 22%) were age, T2D, ethnicity, antihypertensive and lipid-lowering medication, cumulative tobacco consumption, retinopathy, macular edema and macrovascular disease. Multivariable analysis considering all these determinants as well as gender and BMI showed that EAT volume was independently associated with CAC ≥ 100 AU (per 10 cm3 increase: OR 1.11 [1.02-1.20]). Conclusions: EAT volume was independently associated with CAC. As it may play a role in coronary atherosclerosis in patients with diabetes, reducing EAT volume through physical exercise, improved diet and pharmaceutical interventions may improve future cardiovascular risk outcomes in this population.

scholarly journals Epicardial adipose tissue volume and myocardial ischemia in asymptomatic people living with diabetes: a cross-sectional study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Emmanuel Cosson ◽  
Minh Tuan Nguyen ◽  
Imen Rezgani ◽  
Narimane Berkane ◽  
Sara Pinto ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Body Mass Index ◽  
Adipose Tissue ◽  
Myocardial Ischemia ◽  
Body Mass ◽  
Epicardial Adipose Tissue ◽  
Macrovascular Disease ◽  
Diabetes Duration ◽  
Atherogenic Dyslipidemia ◽  
Patients With Diabetes

Abstract Background Epicardial adipose tissue (EAT) is considered a novel diagnostic marker for cardiometabolic disease. This study aimed to evaluate whether EAT volume was associated with stress-induced myocardial ischemia in asymptomatic people living with diabetes—independently of confounding factors—and whether it could predict this condition. Methods We included asymptomatic patients with diabetes and no coronary history, who had undergone both a stress a myocardial scintigraphy to diagnose myocardial ischemia, and a computed tomography to measure their coronary artery calcium (CAC) score. EAT volume was retrospectively measured from computed tomography imaging. Determinants of EAT volume and asymptomatic myocardial ischemia were evaluated. Results The study population comprised 274 individuals, including 153 men. Mean (± standard deviation) age was 62 ± 9 years, and 243, 23 and 8 had type 2, type 1, or another type of diabetes, respectively. Mean body mass index was 30 ± 6 kg/m2, and mean EAT volume 96 ± 36 cm3. Myocardial ischemia was detected in 32 patients (11.7%). EAT volume was positively correlated with age, body mass index and triglyceridemia, but negatively correlated with HbA1c, HDL- and LDL-cholesterol levels. Furthermore, EAT volume was lower in people with retinopathy, but higher in men, in current smokers, in patients with nephropathy, those with a CAC score > 100 Agatston units, and finally in individuals with myocardial ischemia (110 ± 37 cm3 vs 94 ± 37 cm3 in those without myocardial ischemia, p < 0.05). The association between EAT volume and myocardial ischemia remained significant after adjustment for gender, diabetes duration, peripheral macrovascular disease and CAC score. We also found that area under the ROC curve analysis showed that EAT volume (AROC: 0.771 [95% confidence interval 0.683–0.858]) did not provide improved discrimination of myocardial ischemia over the following classic factors: gender, diabetes duration, peripheral macrovascular disease, retinopathy, nephropathy, smoking, atherogenic dyslipidemia, and CAC score (AROC 0.773 [0.683–0.862]). Conclusions EAT may play a role in coronary atherosclerosis and coronary circulation in patients with diabetes. However, considering EAT volume is not a better marker for discriminating the risk of asymptomatic myocardial ischemia than classic clinical data.

Association of Blood Lipids With Coronary Artery Plaque Among Saudi Patients Referred to Computed Tomography

2021 ◽  
Author(s):  
Sumaya Al Helali ◽  
Muhammad Hanif ◽  
Ahmad AlMajed ◽  
Nura AlShugair ◽  
Abdullah Belfageih ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Saudi Arabia ◽  
Blood Lipids ◽  
Hdl Cholesterol ◽  
Coronary Calcification ◽  
Lipid Lowering ◽  
Aged Patients ◽  
Asymptomatic Patients ◽  
Gender Specific ◽  
Saudi Patients

Abstract BACKGROUND: Blood lipids are strong risk factor for the progression of atherosclerotic plaques. However, data on gender-specific associations are limited OBJECTIVES: To examine gender-specific associations of blood lipids with coronary plaque among in a large sample of asymptomatic Saudi patients. METHODS: Retrospective cross-sectional study was conducted among adult patients referred to (64 multidetector spiral) computed tomography (CT) for standard indications at the Prince Sultan Cardiac Centre (Riyadh, Saudi Arabia) between July 2007 and December 2017. Those with pre-existing CAD were excluded. Plaques were determined based on post-test CT angiography and coronary calcification. RESULTS: A total 2421 patients (1498 males and 923 females) were included. The prevalence of any plaque was 36.6% with higher burden in males than females (41.3% versus 28.9%, p<0.001). Approximately 78.9% of all plaques were calcified. Blood lipids (mmol/L) were 4.75±1.14 for total cholesterol, 2.90±0.96 for LDL cholesterol, 1.20±0.36 for HDL cholesterol, and 1.64±1.09 for triglycerides. Males had significantly higher triglycerides and lower HDL cholesterol compared with females. In adjusted models in males and all patients, soft and/or calcified plaques were significantly associated with lower HDL cholesterol and higher triglycerides. In females, the only significant association was between soft plaques and higher triglycerides.CONCLUSIONS: Middle-aged patients without clinical CAD in Saudi Arabia have a high burden of plaques, specially calcified ones. The findings may impact the use of lipid lowering mediations, by underscoring the importance of assessing the risk of CAD in asymptomatic patients without clinical CAD even in case of lack of coronary calcification.

The Relationship Between Visceral Adiposity Index and Epicardial Adipose Tissue in Patients with Type 2 Diabetes Mellitus

2019 ◽  
Author(s):  
Ismail Baloglu ◽  
Kultigin Turkmen ◽  
Nedim Selcuk ◽  
Halil Tonbul ◽  
Adalet Ozcicek ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Adipose Tissue ◽  
Epicardial Adipose Tissue ◽  
Visceral Adiposity ◽  
Visceral Adiposity Index ◽  
Patients With Diabetes ◽  
The Relationship

Abstract Introduction and aim Cardiovascular diseases remain the most common cause of morbidity and mortality in patients with diabetes. Epicardial adipose tissue (EAT), visceral fat depot of the heart, was found to be associated with coronary artery disease in cardiac and non-cardiac patients. Increased visceral adiposity is associated with proinflammatory activity, impaired insulin sensitivity, increased risk of atherosclerosis and high mortality. In the present study we aimed to investigate the relationship between EAT and visceral adiposity index (VAI) in patients with diabetes. Methods This was a cross-sectional study involving 128 patients with type 2 diabetes mellitus (73 females, 55 males; mean age, 54.09+±+9.17 years) and 32 control subjects (23 females, 9 males; mean age, 50.09+±+7.81 years). EAT was measured by using a trans-thoracic echocardiograph. Parameters such as waist circumference (WC), body mass index (BMI), triglyceride and high density lipoprotein (HDL) cholesterol were used to calculate VAI. Result EAT and VAI measurements were significantly higher in patients with diabetes when compared to control subjects. In the bivariate correlation analysis, VAI was positively correlated with uric acid level (r=0.214, p=0.015), white blood cell count (r= 0.262, p=0.003), platelet count (r=0.223, p=0.011) and total cholesterol levels (r= 0.363, p<0.001). Also, VAI was found to be the independent predictor of EAT. Conclusion Simple calculation of VAI was found to be associated with increased EAT in patients with type 2 diabetes.

Visceral Fat Is an Independent Predictor of Cerebral Microbleeds in Neurologically Healthy People

2016 ◽  
Vol 42 (1-2) ◽  
pp. 90-96 ◽  
Author(s):  
Hyung-Min Kwon ◽  
Jong-Ho Park ◽  
Jin Ho Park ◽  
Han-Yeong Jeong ◽  
Jae-Sung Lim ◽  
...  
Keyword(s):  
Adipose Tissue ◽  
Visceral Fat ◽  
Small Vessel Disease ◽  
Brain Mri ◽  
Multivariable Analysis ◽  
Clinical Information ◽  
Cerebral Microbleeds ◽  
Healthy People ◽  
Anthropometric Parameters ◽  
Cross Sectional

Background: Obesity has a significant contribution to the risk of intracerebral hemorrhage (ICH). However, little is known about the association between central obesity and the presence of cerebral microbleeds (CMBs), a precursor of ICH. We sought to assess whether visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) are associated with the presence of CMB. Methods: We conducted a cross-sectional study of 1,737 neurologically healthy people (mean age 55.9 ± 9.1; 790 men), who underwent brain MRI and abdominal CT. Risk factors, anthropometric parameters and clinical information were obtained. CMBs were evaluated through T2*-weighted gradient-recalled echo MRI. The cross-sectional surface areas of the abdominal fat compartments were calculated. Study subjects were stratified into quartiles according to the distribution of VAT/SAT ratio. Results: A total of 75 (4.3%) subjects were found to have CMBs. Subjects with a greater quartile of VAT/SAT ratio were more likely to have higher numbers of CMBs (0 to ≥2; p = 0.001). In multivariable analysis, age and history of hypertension were associated with the presence of CMB (OR 1.09, 95% CI 1.06-1.13, p < 0.001; OR 1.70, 95% CI 1.01-2.84, p = 0.046, respectively). A dose-response relationship was observed between the extent of VAT/SAT quartile and CMB: compared to the lowest VAT/SAT quartile, OR 2.14 (95% CI 0.86-5.35) for second VAT/SAT quartile; OR 2.26 (95% CI 0.86-5.92) for third VAT/SAT quartile; and OR 2.91 (95% CI 1.04-8.12) for the highest VAT/SAT quartile (p for trend 0.03). Conclusion: In our study, higher VAT/SAT ratios were found to be independent predictors of CMBs in neurologically healthy people. This finding strengthens previous data, suggesting that visceral fat distribution is an important contributor to cerebral small vessel disease.

scholarly journals Non-HDL Cholesterol Versus LDL Cholesterol as a CVD Risk Factor in Diabetic Subjects

2014 ◽  
Vol 31 (4) ◽  
pp. 199-203
Author(s):  
M Saiedullah ◽  
S Begum ◽  
S Hayat ◽  
SM Kamahuddin ◽  
MR Rahman ◽  
...  
Keyword(s):  
Risk Factor ◽  
Ldl Cholesterol ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Hdl Cholesterol ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Upward Trend ◽  
Cvd Risk ◽  
Cross Sectional

Objective: Serum low density lipoprotein (LDL) cholesterol is considered as the primary target of lipid lowering therapy and non-high density lipoprotein (HDL) cholesterol is the recommended second target. Recent studies claimed that non-HDL cholesterol is a better predictor of cardiovascular diseases (CVD) than LDL cholesterol. In this study we aimed to compare non-HDL cholesterol and LDL cholesterol as a CVD risk factor in confirmed diabetic subjects. Materials and methods: In this cross-sectional observational study, 1042 confirmed diabetic subjects selected randomly were included. HbA1cResults: In the total subjects, 767 (74%) subjects had LDL cholesterol > 100 mg/dL and 822 (79%) subjects had non- HDL cholesterol > 130 mg/dL. HbA1c values were different (p<0.02) in five groups and showed upward trend (p<0.01). All the lipid parameters studied were significantly different in five groups (p<0.0001) and TC, TG and non-HDL cholesterol showed upward trend (p<0.0001), but HDL cholesterol and LDL cholesterol showed downward trend (p<0.0001). Odds ratio (OR) of likelihood of risk individuals regarding non-HDL cholesterol compared to LDL cholesterol were 0.50 (p<0.001), 1.32 (p>0.05), 2.96 (p<0.001), 6.49 (p<0.001) and 9.37 (p<0.001) for TG concentrations of up to 150 mg/dL, 151-200 mg/dL, 201-250 mg/dL, 251-300 mg/dL and 301-400 mg/dL respectively with relative risk of 0.60, 1.24, 2.43, 4.83, 5.10. Conclusion: LDL cholesterol is a better tool for the detection of high-risk individuals than non-HDL cholesterol at TG concentration up to 150 mg/dL, whereas non-HDL cholesterol is better than LDL cholesterol at TG concentration above 200 mg/dL as a CVD risk factor. DOI: http://dx.doi.org/10.3329/jbcps.v31i4.21004 J Bangladesh Coll Phys Surg 2013; 31: 199-203

scholarly journals Cross-sectional study of pattern of Dyslipidemia and Prevalence of Atherogenic Diabetic Dyslipidemia in newly detected Diabetic patients

2019 ◽  
Vol 10 (6) ◽  
pp. 45-49
Author(s):  
Vinay Krishnamurthy ◽  
Akhila Rao Kerekoppa ◽  
Prabhakar B
Keyword(s):  
Tertiary Care ◽  
Hdl Cholesterol ◽  
Cross Sectional Study ◽  
Lipid Lowering ◽  
Diabetic Patients ◽  
Lipid Lowering Therapy ◽  
Newly Diagnosed ◽  
Diabetic Dyslipidemia ◽  
Cross Sectional ◽  
Treatment Naïve

Background: India has seen an ever increasing number of diabetic patients and in turn rise in cardiovascular diseases. Many studies have shown diabetic patients to have dyslipidemia, with certain common patterns early in the disease. Aims and Objective: The current study was done to identify pattern of dyslipidemia and prevalence of ADD in treatment naïve diabetic patients. Material and Methods: Fasting lipid profile was analysed in treatment naïve diabetic patients at a tertiary care teaching hospital. Various factors influencing the results were analysed statistically. Results: Prevalence of dyslipidemia was 89.2%, whereasatherogenic diabetic dyslipidemia was seen in 34.2% and raised non-HDL cholesterol in 73.3%. Conclusion: Our study showed a high prevalence of dyslipidemia in newly diagnosed diabetics indicating the importance of screening for dyslipidemia in newly diagnosed cases and implementation of timely lipid lowering therapy to prevent CVD. It also highlights the importance of pattern of dyslipidemia called Atherogenic diabetic dyslipidemia and raised Non-HDL cholesterol in diabetic patients.

Abstract P304: Fatty liver disease is Associated with Aortic Valve Sclerosis in the General Population

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Wolfgang Lieb ◽  
Marcello R Markus ◽  
Sebastian E Baumeister ◽  
Henri Wallaschofski ◽  
Marcus Dörr ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
Liver Disease ◽  
Aortic Valve ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Hdl Cholesterol ◽  
Lipid Lowering ◽  
Aortic Valve Sclerosis ◽  
Cross Sectional ◽  
Cholesterol Ratio

Background: Fatty liver disease has been linked to increased cardiovascular risk and mortality, but the precise mechanisms are incompletely understood. We aimed to assess whether fatty liver disease is associated with aortic valve sclerosis in the community. Methods: Cross-sectional data (1,150 men and 1,087 women, aged 45–81 years) from the population-based Study of Health in Pomerania (SHIP), in northeast Germany, were analyzed. Fatty liver disease was defined as a hyperechogenic ultrasound pattern of the liver in conjunction with increased serum alanine aminotransferase levels. Aortic valve sclerosis was determined by echocardiography and defined as an abnormal irregular thickening and a focal or diffuse increase of the echogenicity of the leaflets. Results: The prevalences of fatty liver disease and aortic valve sclerosis were 15.6% and 32.5%, respectively. Among participants with fatty liver disease, aortic valve sclerosis was much more common than in indivivuals without fatty liver disease (prevalence aortic valve sclerosis 38.3% vs. 29.2%; p=0.001). Upon adjustment for confounding factors (including age, sex, waist circumference, alcohol consumption, physical activity, systolic blood pressure, antihypertensive medication, total/HDL cholesterol ratio, lipid-lowering medication, HBA1c, anti-diabetic medication, and estimated glomerular filtration rate), individuals with fatty liver disease had 38% higher odds ratio of presenting with aortic valve sclerosis as compared to those without fatty liver disease (95% confidence interval, OR 1.02 to 1.88). Conclusions: Our findings are consistent with the hypothesis that fatty liver disease is associated with aortic valve sclerosis, independently of classic cardiovascular risk factors. Metabolic changes secondary to fatty liver disease may have a pro-atherogenic effect promoting the development of the aortic valve calcification and sclerosis.

Sign in / Sign up

Export Citation Format

Share Document