Relation of Epicardial Fat Thickness with Carotid Intima-Media Thickness in Patients with Type 2 Diabetes Mellitus

Abstract

Aims. The aim of this study was to investigate the relationship of echocardiographic epicardial fat thickness (EFT) with carotid intima-media thickness (CIMT), in patients with type 2 diabetes mellitus (T2DM). Methods and Results. A total of 139 patients with T2DM (mean age 54.3 ± 9.2 and 49.6% male) and 40 age and sex-matched control subjects were evaluated. Echocardiographic EFT and ultrasonographic CIMT were measured in all subjects. Patients with T2DM had significantly increased EFT and CIMT than those of the controls (6.0 ± 1.5 mm versus 4.42 ± 1.0 mm, P < 0.001 and 0.76 ± 0.17 mm versus 0.57 ± 0.14 mm, P < 0.001, resp.). EFT was correlated with CIMT, waist circumference, BMI, age, duration of T2DM, HbA1c in the type 2 diabetic patients. Linear regression analysis showed that CIMT (β = 3.52, t = 3.72, P < 0.001) and waist circumference (β = 0.36, t = 2.26, P = 0.03) were found to be independent predictors of EFT. A cutoff high risk EFT value of 6.3 mm showed a sensitivity and specificity of 72.5% and 71.7%, respectively, for the prediction of subclinical atherosclerosis. Conclusion. We found that echocardiographic EFT was significantly higher in patients with T2DM. Our study also showed that EFT was strongly correlated with waist circumference and CIMT as being independent of sex.

Does Gestational Diabetes History Increase Epicardial Fat and Carotid Intima Media Thickness?

“…In a crosssectional study, 25 women with gestational diabetes history were compared with women without GDM, 1 year after their delivery and CRP and interleukin-6 levels were found higher in patients with GDM compared to normal women. 25 Cetin et al 26 reported the same correlation in patients with type 2 diabetes and Colak et al 27 found that patients with nonalcoholic fatty liver disease have high EFT and c-IMT levels independent of metabolic syndrome. 23,24 In recent years, inflammation has found to be linked to atherosclerosis.…”

“…This relationship has been found in various studies investigating diseases that are manifestations of IR. 25 Cetin et al 26 reported the same correlation in patients with type 2 diabetes and Colak et al 27 found that patients with nonalcoholic fatty liver disease have high EFT and c-IMT levels independent of metabolic syndrome. These results may indicate an association between EFT and atherosclerosis.…”

Serum paraoxonase activity is associated with epicardial fat tissue in renal transplant recipients

“…According to these findings, recent interest has shifted towards the role of EFT in CVD in both renal and non-renal patients. Increased EFT thickness, as obtained by echocardiography, is related with atherosclerosis in patients with diabetes and also hypertension [35,36]. Turkmen et al [37] found that that EFT was increased in ESRD patients and a positive correlation between EFT and malnutrition-inflammationatherosclerosis syndrome was revealed in their study.…”

Epicardial fat thickness and carotid intima-media thickness in patients with type 2 diabetes mellitus

“…Recently, in a study performed by Kim et al, 30 increased EAT thickness assessed by cardiovascular magnetic resonance (CMR) was an independent risk factor for significant coronary artery stenosis in asymptomatic type 2 diabetes. Mustafa Cetin et al, 21 observed in their study that the echocardiographic EFT was significantly higher in patients with T2DM and also showed that EFT was strongly correlated with waist circumference and CIMT as being independent of sex. In another study reported by Wang et al, 31 EAT volume assessed by cardiac multislice computed tomography was shown to be increased and was associated with unfavourable components of MetS and coronary atherosclerosis in type 2 diabetic patients.…”