High pericardial and peri-aortic adipose tissue burden in pre-diabetic and diabetic subjects

• Published in: BMC cardiovascular disorders 2013-11, Vol.13 (1), p.98-98, Article 98
• Main Authors: Yang, Fei-Shih, Yun, Chun-Ho, Wu, Tung-Hsin, Hsieh, Ya-Ching, Bezerra, Hiram G, Liu, Chuan-Chuan, Wu, Yih-Jer, Kuo, Jen-Yuan, Hung, Chung-Lieh, Hou, Charles Jia-Yin, Yeh, Hung-I, Lee, Jason Jeun-Shenn, Bulwer, Bernard E, Cury, Ricardo C
• Format: Article
• Language: English
• Subjects: Acquisitions & mergers; Adipose Tissue - pathology; Adult; Aorta, Thoracic - pathology; Body fat; C-reactive protein; Complications and side effects; Coronary vessels; Cross-Sectional Studies; CT imaging; Development and progression; Dextrose; Diabetes; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - diagnosis; Diabetes Mellitus, Type 2 - epidemiology; Diabetics; Diagnosis; Diet; Family medical history; Female; Glucose; Glucose Tolerance Test - trends; Health Surveys - trends; Heart attacks; Hospitalization; Humans; Insulin; Insulin resistance; Male; Medicine; Middle Aged; Obesity; Pericardium - pathology; Prediabetic State - blood; Prediabetic State - diagnosis; Prediabetic State - epidemiology; Risk factors; Studies; Taiwan - epidemiology; Tomography; Type 2 diabetes; Womens health; Work stations
• ISSN: 1471-2261; 1471-2261
• DOI: 10.1186/1471-2261-13-98

Central obesity in relation to insulin resistance is strongly linked to the development of type 2 diabetes. However, data regarding the association between pericardial and peri-aortic adiposity, a potential estimate of visceral adipose tissue burden, and pre-diabetes status remains unclear.The aim of this study was to examine whether the degree of pericardial and thoracic peri-aortic adipose tissue, when quantified by multi-detector computed tomography (MDCT), differs significantly in a normal, pre-diabetic, and overtly diabetic population. We studied 562 consecutive subjects including 357 healthy, 155 pre-diabetic, and 50 diabetic patients selected from participants who underwent annual health surveys in Taiwan. Pre-diabetes status was defined by impaired fasting glucose or impaired glucose intolerance according to American Diabetes Association guidelines. Pericardial (PCF) and thoracic peri-aortic (TAT) adipose tissue burden was assessed using a non-contrast 16-slice multi-detector computed tomography (MDCT) dataset with off-line measurement (Aquarius 3D Workstation, TeraRecon, San Mateo, CA, USA). Body fat composition, serum high-sensitivity C-reactive protein (hs-CRP) level and insulin resistance (HOMA-IR) were also assessed. Patients with diabetes and pre-diabetes had greater volume of PCF (89 ± 24.6, 85.3 ± 28.7 & 67.6 ± 26.7 ml, p < 0.001) as well as larger TAT (9.6 ± 3.1 ml vs 8.8 ± 4.2 & 6.6 ± 3.5 ml, respectively, p < 0.001) when compared to the normal group, although there were no significant differences in adiposity between the diabetic and pre-diabetic groups. For those without established diabetes in our study, increasing TAT burden, but not PCF, appear to correlate with insulin resistance (HOMA-IR) and hs-CRP in the multivariable models. Pre-diabetic and diabetic subjects, compared to normoglycemia, were associated with significantly higher pericardial and peri-aortic adipose tissue burden. In addition, visceral fat accumulation adjacent to the thoracic aorta seemed to exert a significant impact on insulin resistance and systemic inflammation.