Epicardial adipose tissue is a predictor of decreased kidney function and coronary artery calcification in youth- and early adult onset type 2 diabetes mellitus

Purpose To examine the association of epicardial and pericardial fat volume (EFV, PFV) with cardiovascular risk factors and kidney function in Native Americans of southwestern heritage with youth and early adult onset type 2 diabetes mellitus (T2DM) versus healthy controls. Methods Using computed tomography, we quantified EFV and PFV in 149 Native Americans (92 women, 57 men), 95 of which had T2DM (38 diagnosed prior to age 20years). Duration of T2DM, mean carotid arterial mass (AM), coronary artery calcification (CAC), IL-6, and estimated glomerular filtration rate eGFR(cr(CKD-EPI)) were measured. Results EFV and PFV were associated with BMI (r=0.37, p<0.0001; r=0.26, p=0.001) and did not differ between onset age-groups and controls (p>0.05). EFV was associated with AM only in controls (r=0.51, p<0.0001). After adjustment for BMI, T2DM duration, HbA1C, age, and sex, EFV was a predictor of CAC and IL-6 concentrations in early adult onset T2DM (beta=0.050.02cm(3), p=0.03; beta=0.05 +/- 0.01pg/ml/cm(3), p=0.002). EFV and PFV were independent predictors of reduced eGFR(cr(CKD-EPI)) in the youth onset T2DM group (beta=-0.3 +/- 0.08ml/min/cm(3), p=0.001; beta=-0.25 +/- 0.05ml/min/cm(3), p<0.0001). Conclusions Eicardial fat volume may be a risk factor for heart disease in individuals with early adult onset T2DM and a predictor of decreased kidney function in individuals with youth onset T2DM.