The relationship between epicardial adipose pad and endothelial dysfunction in patients with type 2 diabetes mellitus

Objectives: Epicardial adipose tissue (EAT) has been shown to be related to cardiovascular risk. The aim of the present study was to investigate the relationship betvveen EAT and endothelial function in patients with type 2 diabetes mellitus (DM). Study design: Type 2 DM patients were divided into two groups according to their brachial flow-mediated dilatation (FMD) values. The endothelial dysfunction (ED) group consisted of 46 patients with FMD change of <7%, while 46 patients with FMD change of >7% were accepted as the non-ED group. EAT thickness was measured on the right ventricular free wall from the transthoracic echocardiographic parasternal long-and short-axis views. The patients' demographic, anthropometric and laboratory fndings were recorded. Results: The mean diameter of EAT was 8.0 +/- 1.8 cm in the ED and 6.6 +/- 1.2 cm in the non-ED groups (p<0.001). HbA1c levels were signifcantly higher in the ED group than non-ED group (8.55 [ 7.30-9.80], 7.45 [6.50-9.30], respectively; p=0.042). There was a negative correlation betvveen FMD values and EAT (r=-0.437, p<0.001). FMD values vvere weakly and negatively correlated vvith duration of DM and HbA1c levels (r=-0.216, p=0.038; r=-0.266, p=0.010, respectively). EAT thickness was strongly correlated vvith body mass index (BMI) and waist length (r=0.405, p<0.001; r=0.515, p<0.001, respectively). The neutrophil count was signifcantly higher in the ED group than in the non-ED group. In multivariate logistic regression analysis, HbAlc levels and EAT thickness were found as predictors of ED in type 2 DM (odds ratio (OR): 1.887, 95% confdence interval (Cl): 1.298-2.743, p=0.001; OR: 1.485, 95% Cl: 1.054-2.093). Conclusion: EAT thickness predicts ED in patients vvith type 2 DM.