Epicardial adipose tissue volume and arterial stiffness in people living with diabetes: the METAB-CV-PWV study.

INTRODUCTION

Epicardial adipose tissue (EAT) and arterial stiffness are determinants of excess risk of cardiovascular disease in persons with diabetes. This study aimed to evaluate the relationship between both of these conditions in a cohort of patients with diabetes.

MATERIALS AND

METHODS

A part retrospective, part prospective non-interventional cohort study of people living with diabetes who had (i) a computed tomography scan to measure both their coronary artery calcium score and EAT volume (proprietary prototype, GE HealthCare), and (ii) a finger-to-toe pulse wave velocity (PWV) measurement to assess arterial stiffness. The study's ClinicalTrials.gov identifier is NCT05681533.

RESULTS

A total of 345 participants (198 men, mean age (± standard deviation (SD)) 55.6 ± 12.6 years) were included; 73.6% had type 2 diabetes and 41.6% had obesity. Median duration of diabetes was 12 [interquartile range (IQR) 6-20] years. The median PWV was 8.0 [IQR 7.0-10.0] m/sec and median EAT volume was 84.9 [IQR 61.8-114.3] cm3. A positive correlation was observed between EAT volume and PWV (r = 0.37 [95% confidence interval (95%CI) 0.27-0.45], p < 0.001). EAT volume was associated with PWV tertile: specifically, participants in the first (≤ 7.0 m/sec), second, and third (> 9.0 m/sec) tertiles had, respectively, EAT volumes of 76.3 [IQR 50.3-100.6] cm3, 82.5 [IQR 64.4-107.3] cm3, and 100.2 [IQR 77.3-134.6] cm3 (p < 0.001 for all three). After adjustment for age, mean blood pressure, body mass index and diabetes type, each 10 cm3 increase in EAT volume was associated with a 14% increase in the probability of belonging to the third PWV tertile (odds ratio 1.14 [95%CI 1.06 - 1.21]; p < 0.001).

CONCLUSION

EAT volume was associated with arterial stiffness in people living with diabetes. This association suggests that systemic inflammatory and metabolic mechanisms, through EAT and/or other associated ectopic adipose tissues, may contribute to an increased risk of cardiovascular disease.