Epicardial adipose thickness in youth with type 1 diabetes

Abstract

Background and Objective Epicardial adipose thickness (EAT) is increased in adults with type 1 diabetes (T1D) and is thought to contribute to cardiovascular disease (CVD) in this population. Given that CVD risk factors emerge early in life, the purpose of this study was to identify whether EAT is increased in pediatric patients with T1D compared with non‐diabetic controls. Methods Anthropometric data, blood pressure (BP), and EAT were evaluated in 20 youth with T1D and 20 age, sex, and body mass index (BMI) matched healthy controls between the ages of 5 and 18 years. Results EAT was 18.5% higher among youth with T1D compared to healthy controls (1.65 ± 0.44 mm vs 1.37 ± 0.27 mm, P = .02). In the entire cohort, EAT was correlated with age (r = 0.71, P < .001), BMI (r = .69, P < .001), waist circumference (r = 0.60, P < .001), systolic BP (r = .34, P = .03), and diastolic BP (r = 0.41, P = .009). Among youth with T1D, there were no significant correlations between EAT and HbA1c (r = −0.16, P = .50), insulin dose (r = .09, P = .71), or duration of disease (r = 0.06, P = .82). Conclusions Youth with T1D exhibited significantly higher EAT compared to controls. Increased EAT was associated with adiposity and BP, but not duration of disease, insulin dose, or glycemic control. Increased EAT may represent a pathophysiologic mechanism leading to premature CVD in pediatric patients with T1D.

Evaluation of epicardial adipose tissue in children with type 1 diabetes

“…In our study, we observed elevated levels of EAT in children with T1D when compared to age, sex, and BMI-matched healthy counterparts. Although studies on this subject in children are limited, the findings were consistent with the studies conducted by Güney et al and Chambers et al 1,2 Although the reason for the increase in epicardial adipose tissue in patients with type 1 diabetes is not fully understood, publications are indicating that this may be related to the insulin dose used, and if the dose used is high or the hba1c is low, this may be related to the high insulin dose. 10,11 On the other hand, it is known that although fat stores are reduced in insulin deficiency, epicardial adipose tissue is protected from this reduction.…”

“…It exhibits a strong link to coronary artery disease and has been shown to play a role in the pathophysiology of This comprehensive review aims to elucidate the complex relationship between EAT and T1D in children by exploring the underlying mechanisms and clinical outcomes, metabolic disorders, inflammation, and cardiovascular diseases. 1,2 In epicardial adipose tissue (EAT) assessment, echocardiography is extensively used due to its widespread availability and noninvasive nature. However, this method grapples with significant limitations, including variability between operators and within the same operator's repeated measurements, alongside an inherent incapacity to accurately gauge EAT volume or delineate specific regional distributions of EAT, such as peri-atrial and pericoronary areas.…”

Epicardial adipose tissue: an emerging biomarker of cardiovascular complications in type 2 diabetes?

“…25 While it is now clear that EAT is increased in patients with T2D, it is not established in type 1 diabetes (T1D). Although some studies do support a role of EAT in cardiac disease in T1D, 90–92 it has recently been reported that EAT volume was not higher and not associated with coronary atherosclerosis in T1D patients. 93 In support of this, we recently found patients with T1D to have lower cardiac adipose tissue volumes compared with patients with T2D, and levels similar to those of controls.…”