Epicardial adipose tissue predicts incident cardiovascular disease and mortality in patients with type 2 diabetes

被引:71
作者
Christensen, Regitse H. [1 ,2 ]
von Scholten, Bernt Johan [2 ]
Hansen, Christian S. [2 ]
Jensen, Magnus T. [3 ,4 ]
Vilsboll, Tina [2 ,5 ]
Rossing, Peter [2 ,5 ]
Jorgensen, Peter G. [4 ]
机构
[1] Rigshosp, Ctr Inflammat & Metab, Ctr Phys Act Res, Copenhagen, Denmark
[2] Steno Diabet Ctr Copenhagen, Gentofte, Denmark
[3] Glostrup Rigshosp, Dept Cardiol, Glostrup, Denmark
[4] Herlev Gentofte Hosp, Dept Cardiol, Hellerup, Denmark
[5] Univ Copenhagen, Fac Hlth & Med Sci, Dept Clin Med, Copenhagen, Denmark
关键词
Epicardial adipose tissue; Pericardial adipose tissue; Cardiovascular disease; Risk prediction; CORONARY-ARTERY CALCIFICATION; HEART-DISEASE; GENDER-DIFFERENCES; PERICARDIAL FAT; RISK-FACTORS; BODY-FAT; ASSOCIATION; VOLUME; SEX; ATHEROSCLEROSIS;
D O I
10.1186/s12933-019-0917-y
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background Cardiac fat is a cardiovascular biomarker but its importance in patients with type 2 diabetes is not clear. The aim was to evaluate the predictive potential of epicardial (EAT), pericardial (PAT) and total cardiac (CAT) fat in type 2 diabetes and elucidate sex differences. Methods EAT and PAT were measured by echocardiography in 1030 patients with type 2 diabetes. Follow-up was performed through national registries. The end-point was the composite of incident cardiovascular disease (CVD) and all-cause mortality. Analyses were unadjusted (model 1), adjusted for age and sex (model 2), plus systolic blood pressure, body mass index (BMI), low-density lipoprotein (LDL), smoking, diabetes duration and glycated hemoglobin (HbA(1c)) (model 3). Results Median follow-up was 4.7 years and 248 patients (191 men vs. 57 women) experienced the composite end-point. Patients with high EAT (> median level) had increased risk of the composite end-point in model 1 [Hazard ratio (HR): 1.46 (1.13; 1.88), p = 0.004], model 2 [HR: 1.31 (1.01; 1.69), p = 0.038], and borderline in model 3 [HR: 1.32 (0.99; 1.77), p = 0.058]. For men, but not women, high EAT was associated with a 41% increased risk of CVD and mortality in model 3 (p = 0.041). Net reclassification index improved when high EAT was added to model 3 (19.6%, p = 0.035). PAT or CAT were not associated with the end-point. Conclusion High levels of EAT were associated with the composite of incident CVD and mortality in patients with type 2 diabetes, particularly in men, after adjusting for CVD risk factors. EAT modestly improved risk prediction over CVD risk factors.
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页数:10
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