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Epicardial adipose tissue predicts incident cardiovascular disease and mortality in patients with type 2 diabetes

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@article{c0a03bd0dfb8486a87c8694a1faaeceb,
title = "Epicardial adipose tissue predicts incident cardiovascular disease and mortality in patients with type 2 diabetes",
abstract = "BACKGROUND: Cardiac fat is a cardiovascular biomarker but its importance in patients with type 2 diabetes is not clear. The aim was to evaluate the predictive potential of epicardial (EAT), pericardial (PAT) and total cardiac (CAT) fat in type 2 diabetes and elucidate sex differences.METHODS: EAT and PAT were measured by echocardiography in 1030 patients with type 2 diabetes. Follow-up was performed through national registries. The end-point was the composite of incident cardiovascular disease (CVD) and all-cause mortality. Analyses were unadjusted (model 1), adjusted for age and sex (model 2), plus systolic blood pressure, body mass index (BMI), low-density lipoprotein (LDL), smoking, diabetes duration and glycated hemoglobin (HbA1c) (model 3).RESULTS: Median follow-up was 4.7 years and 248 patients (191 men vs. 57 women) experienced the composite end-point. Patients with high EAT (> median level) had increased risk of the composite end-point in model 1 [Hazard ratio (HR): 1.46 (1.13; 1.88), p = 0.004], model 2 [HR: 1.31 (1.01; 1.69), p = 0.038], and borderline in model 3 [HR: 1.32 (0.99; 1.77), p = 0.058]. For men, but not women, high EAT was associated with a 41{\%} increased risk of CVD and mortality in model 3 (p = 0.041). Net reclassification index improved when high EAT was added to model 3 (19.6{\%}, p = 0.035). PAT or CAT were not associated with the end-point.CONCLUSION: High levels of EAT were associated with the composite of incident CVD and mortality in patients with type 2 diabetes, particularly in men, after adjusting for CVD risk factors. EAT modestly improved risk prediction over CVD risk factors.",
keywords = "Cardiovascular disease, Epicardial adipose tissue, Pericardial adipose tissue, Risk prediction",
author = "Christensen, {Regitse H} and {von Scholten}, {Bernt Johan} and Hansen, {Christian S} and Jensen, {Magnus T} and Tina Vilsb{\o}ll and Peter Rossing and J{\o}rgensen, {Peter G}",
year = "2019",
month = "8",
day = "30",
doi = "10.1186/s12933-019-0917-y",
language = "English",
volume = "18",
journal = "Cardiovascular Diabetology",
issn = "1475-2840",
publisher = "BioMed Central Ltd",
number = "1",

}

RIS

TY - JOUR

T1 - Epicardial adipose tissue predicts incident cardiovascular disease and mortality in patients with type 2 diabetes

AU - Christensen, Regitse H

AU - von Scholten, Bernt Johan

AU - Hansen, Christian S

AU - Jensen, Magnus T

AU - Vilsbøll, Tina

AU - Rossing, Peter

AU - Jørgensen, Peter G

PY - 2019/8/30

Y1 - 2019/8/30

N2 - BACKGROUND: Cardiac fat is a cardiovascular biomarker but its importance in patients with type 2 diabetes is not clear. The aim was to evaluate the predictive potential of epicardial (EAT), pericardial (PAT) and total cardiac (CAT) fat in type 2 diabetes and elucidate sex differences.METHODS: EAT and PAT were measured by echocardiography in 1030 patients with type 2 diabetes. Follow-up was performed through national registries. The end-point was the composite of incident cardiovascular disease (CVD) and all-cause mortality. Analyses were unadjusted (model 1), adjusted for age and sex (model 2), plus systolic blood pressure, body mass index (BMI), low-density lipoprotein (LDL), smoking, diabetes duration and glycated hemoglobin (HbA1c) (model 3).RESULTS: Median follow-up was 4.7 years and 248 patients (191 men vs. 57 women) experienced the composite end-point. Patients with high EAT (> median level) had increased risk of the composite end-point in model 1 [Hazard ratio (HR): 1.46 (1.13; 1.88), p = 0.004], model 2 [HR: 1.31 (1.01; 1.69), p = 0.038], and borderline in model 3 [HR: 1.32 (0.99; 1.77), p = 0.058]. For men, but not women, high EAT was associated with a 41% increased risk of CVD and mortality in model 3 (p = 0.041). Net reclassification index improved when high EAT was added to model 3 (19.6%, p = 0.035). PAT or CAT were not associated with the end-point.CONCLUSION: High levels of EAT were associated with the composite of incident CVD and mortality in patients with type 2 diabetes, particularly in men, after adjusting for CVD risk factors. EAT modestly improved risk prediction over CVD risk factors.

AB - BACKGROUND: Cardiac fat is a cardiovascular biomarker but its importance in patients with type 2 diabetes is not clear. The aim was to evaluate the predictive potential of epicardial (EAT), pericardial (PAT) and total cardiac (CAT) fat in type 2 diabetes and elucidate sex differences.METHODS: EAT and PAT were measured by echocardiography in 1030 patients with type 2 diabetes. Follow-up was performed through national registries. The end-point was the composite of incident cardiovascular disease (CVD) and all-cause mortality. Analyses were unadjusted (model 1), adjusted for age and sex (model 2), plus systolic blood pressure, body mass index (BMI), low-density lipoprotein (LDL), smoking, diabetes duration and glycated hemoglobin (HbA1c) (model 3).RESULTS: Median follow-up was 4.7 years and 248 patients (191 men vs. 57 women) experienced the composite end-point. Patients with high EAT (> median level) had increased risk of the composite end-point in model 1 [Hazard ratio (HR): 1.46 (1.13; 1.88), p = 0.004], model 2 [HR: 1.31 (1.01; 1.69), p = 0.038], and borderline in model 3 [HR: 1.32 (0.99; 1.77), p = 0.058]. For men, but not women, high EAT was associated with a 41% increased risk of CVD and mortality in model 3 (p = 0.041). Net reclassification index improved when high EAT was added to model 3 (19.6%, p = 0.035). PAT or CAT were not associated with the end-point.CONCLUSION: High levels of EAT were associated with the composite of incident CVD and mortality in patients with type 2 diabetes, particularly in men, after adjusting for CVD risk factors. EAT modestly improved risk prediction over CVD risk factors.

KW - Cardiovascular disease

KW - Epicardial adipose tissue

KW - Pericardial adipose tissue

KW - Risk prediction

UR - http://www.scopus.com/inward/record.url?scp=85071777827&partnerID=8YFLogxK

U2 - 10.1186/s12933-019-0917-y

DO - 10.1186/s12933-019-0917-y

M3 - Journal article

VL - 18

JO - Cardiovascular Diabetology

JF - Cardiovascular Diabetology

SN - 1475-2840

IS - 1

M1 - 114

ER -

ID: 57975699