Epicardial and Pericardial Fat in Type 2 Diabetes: Favourable Effects of Biliopancreatic Diversion

Vasques, Ana Carolina Junqueira; Pareja, José Carlos; Souza, José Roberto Mattos; Yamanaka, Ademar; Oliveira, Maria da Saúde de; Novaes, Fernanda Satake; Chaim, Élinton Adami; Piccinini, Francesca; Man, Chiara Dalla; Cobelli, Claudio; Geloneze, Bruno

doi:10.1007/s11695-014-1400-1

Cited by 10 publications

(7 citation statements)

References 26 publications

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“…The inverse relationship between albumin and EAT suggests that nutritional status and EAT may be related. Studies have reported reduced EAT thickness 12 months after bariatric surgery [ 44 , 45 ]. Accordingly, we need data on weight evolution during a COVID-19 infection to understand the inverse correlation.…”

Section: Discussionmentioning

confidence: 99%

Epicardial adipose tissue and severe Coronavirus Disease 19

Bihan

Heidar

Beloeuvre

et al. 2021

Cardiovasc Diabetol

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Background Both visceral adipose tissue and epicardial adipose tissue (EAT) have pro-inflammatory properties. The former is associated with Coronavirus Disease 19 (COVID-19) severity. We aimed to investigate whether an association also exists for EAT. Material and methods We retrospectively measured EAT volume using computed tomography (CT) scans (semi-automatic software) of inpatients with COVID-19 and analyzed the correlation between EAT volume and anthropometric characteristics and comorbidities. We then analyzed the clinicobiological and radiological parameters associated with severe COVID-19 (O2 $$\ge$$ ≥ 6 l/min), intensive care unit (ICU) admission or death, and 25% or more CT lung involvement, which are three key indicators of COVID-19 severity. Results We included 100 consecutive patients; 63% were men, mean age was 61.8 ± 16.2 years, 47% were obese, 54% had hypertension, 42% diabetes, and 17.2% a cardiovascular event history. Severe COVID-19 (n = 35, 35%) was associated with EAT volume (132 ± 62 vs 104 ± 40 cm3, p = 0.02), age, ferritinemia, and 25% or more CT lung involvement. ICU admission or death (n = 14, 14%) was associated with EAT volume (153 ± 67 vs 108 ± 45 cm3, p = 0.015), hypertension and 25% or more CT lung involvement. The association between EAT volume and severe COVID-19 remained after adjustment for sex, BMI, ferritinemia and lung involvement, but not after adjustment for age. Instead, the association between EAT volume and ICU admission or death remained after adjustment for all five of these parameters. Conclusions Our results suggest that measuring EAT volume on chest CT scans at hospital admission in patients diagnosed with COVID-19 might help to assess the risk of disease aggravation.

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Section: Discussionmentioning

confidence: 99%

Epicardial adipose tissue and severe Coronavirus Disease 19

Bihan

Heidar

Beloeuvre

et al. 2021

Cardiovasc Diabetol

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“…A further 196 studies lacked sufficient data, 5 were studies of animals, and 1 was excluded because it was not published in English. Therefore, our final analysis included 13 studies (1102 patients with DM and 813 healthy control subjects) that measured EFT in a DM group and a control group [20,21,[27][28][29][30][31][32][33][34][35][36][37] (Fig. 1).…”

Section: Description Of the Studiesmentioning

confidence: 99%

“…We should consider some potential limitations of this study. First, five studies included [20,[28][29][30]35] were small sample size. Second, there are limited studies in some subgroup analysis, and more studies are needed to support these results.…”

Section: Limitationsmentioning

confidence: 99%

Epicardial fat tissue in patients with diabetes mellitus: a systematic review and meta-analysis

Liu

et al. 2019

Cardiovasc Diabetol

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Background: Epicardial fat tissue (EFT) is the visceral fat distributed along the coronary arteries between the pericardium and the myocardium. Increases in EFT are closely related to the occurrence of diabetes mellitus (DM) and cardiovascular disease. To further understand the link between EFT and DM, we conducted a meta-analysis of the relevant literature. Methods: We systematically searched electronic databases for studies on EFT performed in DM patients and published up to 30 September 2018. We included data on EFT in a DM patient group and a non-DM control group. We then assessed the effect of DM on EFT by meta-analysis and trial sequential analysis (TSA). All statistical analyses were performed using Stata 12.0 and TSA software. Results: A total of 13 studies (n = 1102 patients) were included in the final analysis. Compared with the control group, DM patients had significantly higher EFT (SMD: 1.23; 95% CI 0.98, 1.48; P = 0.000; TSA-adjusted 95% CI 0.91, 2.13; P < 0.0001). The TSA indicated that the available samples were sufficient and confirmed that firm evidence was reached. According to the regression analysis and subgroup analyses, DM typing, EFT ultrasound measurements, total cholesterol (TC) and triglyceride (TG) levels were confounding factors that significantly affected our results. Conclusions: Our meta-analysis suggests that the amount of EFT is significantly higher in DM patients than in non-DM patients.

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“…Kokkinos et al report a greater reduction in EAT with Roux-en-Y procedure than sleeve gastroplasty, despite similar weight loss or reduction in waist circumference [ 144 ]. In a study using biliopancreatic diversion, a rapid reduction in SAT and visceral adipose tissue was observed, whereas EAT and PAT exhibited a significant decrease at the 12-month assessment [ 145 ]. A study comparing these three weight loss strategies reports that the relationship between change in BMI and change in EAT is significant for diet, less apparent for bariatric surgery, and virtually absent for exercise [ 146 ].…”

Section: Therapeutic Interventions Modifying Eatmentioning

confidence: 99%

Dysregulated Epicardial Adipose Tissue as a Risk Factor and Potential Therapeutic Target of Heart Failure with Preserved Ejection Fraction in Diabetes

et al. 2022

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Cardiovascular (CV) disease and heart failure (HF) are the leading cause of mortality in type 2 diabetes (T2DM), a metabolic disease which represents a fast-growing health challenge worldwide. Specifically, T2DM induces a cluster of systemic metabolic and non-metabolic signaling which may promote myocardium derangements such as inflammation, fibrosis, and myocyte stiffness, which represent the hallmarks of heart failure with preserved ejection fraction (HFpEF). On the other hand, several observational studies have reported that patients with T2DM have an abnormally enlarged and biologically transformed epicardial adipose tissue (EAT) compared with non-diabetic controls. This expanded EAT not only causes a mechanical constriction of the diastolic filling but is also a source of pro-inflammatory mediators capable of causing inflammation, microcirculatory dysfunction and fibrosis of the underlying myocardium, thus impairing the relaxability of the left ventricle and increasing its filling pressure. In addition to representing a potential CV risk factor, emerging evidence shows that EAT may guide the therapeutic decision in diabetic patients as drugs such as metformin, glucagon-like peptide‑1 (GLP-1) receptor agonists and sodium-glucose cotransporter 2 inhibitors (SGLT2-Is), have been associated with attenuation of EAT enlargement.

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Epicardial and Pericardial Fat in Type 2 Diabetes: Favourable Effects of Biliopancreatic Diversion

Abstract: After BPD, positive physiological adaptations occurred in grade I and II obese patients with T2DM. These adaptations relate to the restoration of IS and decreased adiposopathy and explain the acute (1 month) and chronic (12 months) improvements in the glycaemic control.

Cited by 10 publications

References 26 publications

Epicardial adipose tissue and severe Coronavirus Disease 19

Epicardial adipose tissue and severe Coronavirus Disease 19

Epicardial fat tissue in patients with diabetes mellitus: a systematic review and meta-analysis

Dysregulated Epicardial Adipose Tissue as a Risk Factor and Potential Therapeutic Target of Heart Failure with Preserved Ejection Fraction in Diabetes

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