Background
Methods
Subjects
Cardiac magnetic resonance (CMR) examination
Image analysis and epicardial adipose tissue (EAT) quantification
Statistical analysis
Results
Baseline characteristics of the study participants
Total (n = 100) | Male (n = 51) | Female (n = 49) |
p value
| |
---|---|---|---|---|
Age (years) | 56 ± 7 | 55 ± 7 | 57 ± 7 | 0.277 |
Body-mass index (kg/m2) | 25.3 ± 3.2 | 25.1 ± 3.2 | 25.6 ± 3.3 | 0.434 |
Waist circumference (cm) | 86.2 ± 8.0 | 87.7 ± 7.2 | 84.6 ± 8.5 | 0.059 |
Waist-to-hip ratio | 0.91 ± 0.06 | 0.91 ± 0.05 | 0.90 ± 0.06 | 0.303 |
Systolic blood pressure (mmHg) | 130 ± 13 | 133 ± 13 | 127 ± 12 | 0.013* |
Diastolic blood pressure (mmHg) | 76 ± 9 | 79 ± 9 | 73 ± 9 | 0.002** |
DM duration (years) | 8.4 ± 6.7 | 8.5 ± 7.1 | 8.2 ± 6.3 | 0.803 |
Fasting glucose (mmol/L) | 6.7 ± 1.7 | 6.9 ± 1.8 | 6.6 ± 1.5 | 0.398 |
Postprandial glucose (mmol/L) | 12.5 ± 3.8 | 11.8 ± 3.9 | 13.1 ± 3.7 | 0.104 |
HbA1c (%) | 7.0 ± 0.9 | 7.0 ± 1.0 | 7.1 ± 0.8 | 0.801 |
GA (%) | 16.7 ± 3.9 | 16.8 ± 4.3 | 16.6 ± 3.4 | 0.782 |
Total cholesterol (mmol/L) | 4.3 ± 0.8 | 4.2 ± 0.8 | 4.5 ± 0.8 | 0.056 |
LDL cholesterol (mmol/L) | 2.5 ± 0.8 | 2.4 ± 0.6 | 2.6 ± 0.9 | 0.115 |
HDL cholesterol (mmol/L) | 1.1 ± 0.2 | 1.1 ± 0.2 | 1.2 ± 0.2 | 0.101 |
Triglyceride (mmol/L) | 1.5 ± 0.7 | 1.4 ± 0.6 | 1.6 ± 0.8 | 0.139 |
HOMA-IR | 4.9 ± 7.8 | 3.0 ± 0.2 | 6.6 ± 1.5 | 0.032* |
Cardiovascular magnetic resonance | ||||
EAT thickness (mm) | 11.9 ± 2.3 | 12.0 ± 2.1 | 11.8 ± 2.5 | 0.738 |
LV ejection fraction (%) | 68 ± 3 | 67 ± 3 | 69 ± 3 | 0.026* |
LV mass (g) | 83 ± 21 | 94 ± 19 | 71 ± 16 | <0.001*** |
n (%) | ||||
Hypertension | 45 (45.0) | 20 (39.2) | 25 (51.0) | 0.184 |
Smoking Hx | 18 (18.0) | 18 (36.7) | 0 (0) | <0.001*** |
Cardiovascular magnetic resonance | ||||
Silent myocardial ischemia | 14 (14.0) | 7 (13.7) | 7 (14.3) | 0.581 |
Silent infarction | 3 (3.0) | 2 (3.9) | 1 (2.0) | 0.515 |
Inducible ischemia | 13 (13.0) | 6 (11.8) | 7 (14.3) | 0.469 |
Both | 2 (2.0) | 1(1.9) | 1(2.0) | 0.742 |
Significant stenosis | 24 (24.0) | 14 (27.5) | 10 (20.4) | 0.278 |
Correlation of EAT thickness with metabolic parameters
Simple regression analysis | ||
---|---|---|
r
| Pvalue | |
Age | 0.042 | 0.677 |
Body-mass index | 0.26 | 0.009** |
Waist circumference | 0.297 | 0.003** |
Waist-to-hip ratio | 0.404 | < 0.001*** |
Systolic blood pressure | 0.223 | 0.027* |
Diastolic blood pressure | 0.175 | 0.085 |
Fasting glucose | 0.105 | 0.298 |
Postprandial glucose | 0.197 | 0.049* |
Fasting TG | 0.256 | 0.01* |
Postprandial TG | 0.272 | 0.009** |
Fasting insulin | 0.193 | 0.058 |
HbA1c | 0.324 | < 0.001*** |
GA | 0.19 | 0.065 |
LDL cholesterol | −0.012 | 0.904 |
HDL cholesterol | −0.115 | 0.254 |
HOMA-IR | 0.21 | 0.047* |
Association of EAT thickness with significant coronary artery stenosis or silent myocardial ischemia
Significant coronary artery stenosis (n = 24) | No significant coronary artery stenosis (n = 76) |
p value
| |
---|---|---|---|
Age (years) | 60 ± 6 | 55 ± 7 | 0.002** |
Body-mass index (kg/m2) | 26.1 ± 3.6 | 25.1 ± 3.1 | 0.240 |
Waist-to-hip ratio | 0.93 ± 0.05 | 0.90 ± 0.06 | 0.015* |
Systolic blood pressure (mmHg) | 137 ± 13 | 128 ± 12 | 0.009** |
Diastolic blood pressure (mmHg) | 76 ± 9 | 77 ± 9 | 0.492 |
DM duration (years) | 9.4 ± 6.6 | 8.0 ± 6.7 | 0.261 |
Smoking history (n, %) | 4 (16.7) | 14 (18.9) | 0.536 |
Fasting glucose (mmol/L) | 7.0 ± 1.9 | 6.6 ± 1.6 | 0.617 |
Postprandial glucose (mmol/L) | 13.0 ± 3.1 | 12.3 ± 4.0 | 0.26 |
HbA1c (%) | 7.1 ± 0.9 | 7.0 ± 0.9 | 0.731 |
GA (%) | 17.8 ± 3.4 | 16.4 ± 4.0 | 0.039* |
Total cholesterol (mmol/L) | 4.7 ± 0.7 | 4.3 ± 0.8 | 0.038* |
LDL cholesterol (mmol/L) | 2.8 ± 0.9 | 2.4 ± 0.7 | 0.104 |
HDL cholesterol (mmol/L) | 1.1 ± 0.2 | 1.1 ± 0.2 | 0.753 |
Triglyceride (mmol/L) | 1.6 ± 0.7 | 1.4 ± 0.7 | 0.212 |
HOMA-IR | 7.0 ± 11.7 | 4.3 ± 6.2 | 0.22 |
Cardiovascular magnetic resonance | |||
EAT thickness (mm) | 13.0 ± 2.6 | 11.5 ± 2.1 | 0.01** |
LV ejection fraction (%) | 69 ± 4 | 68 ± 3 | 0.488 |
LV mass (g) | 90 ± 24 | 81 ± 19 | 0.065 |
Silent myocardial ischemia (n = 14) | No silent myocardial ischemia (n = 86) |
p value
| |
---|---|---|---|
Age (years) | 58 ± 8 | 56 ± 7 | 0.278 |
Body-mass index (kg/m2) | 27.3 ± 3.8 | 25.0 ± 3.0 | 0.033* |
Waist-to-hip ratio | 0.94 ± 0.06 | 0.90 ± 0.05 | 0.087 |
Systolic blood pressure (mmHg) | 133 ± 9 | 130 ± 13 | 0.358 |
Diastolic blood pressure (mmHg) | 74 ± 6 | 77 ± 10 | 0.305 |
DM duration (years) | 10.1 ± 7.5 | 8.1 ± 6.5 | 0.396 |
Smoking history (n, %) | 2 (14.3) | 16 (19.0) | 0.503 |
Fasting glucose (mmol/L) | 6.3 ± 2.0 | 6.8 ± 1.6 | 0.072 |
Postprandial glucose (mmol/L) | 13.4 ± 3.6 | 12.3 ± 3.9 | 0.200 |
HbA1c (%) | 7.2 ± 0.8 | 7.0 ± 0.9 | 0.236 |
GA (%) | 17.9 ± 3.9 | 16.5 ± 3.9 | 0.203 |
Total cholesterol (mmol/L) | 4.4 ± 0.9 | 4.3 ± 0.8 | 0.941 |
LDL cholesterol (mmol/L) | 2.7 ± 1.3 | 2.4 ± 0.7 | 0.602 |
HDL cholesterol (mmol/L) | 1.2 ± 0.2 | 1.1 ± 0.2 | 0.453 |
Triglyceride (mmol/L) | 1.3 ± 0.5 | 1.5 ± 0.7 | 0.295 |
HOMA-IR | 4.4 ± 3.5 | 5.0 ± 8.2 | 0.649 |
Cardiovascular magnetic resonance | |||
EAT thickness (mm) | 12.8 ± 2.1 | 11.7 ± 2.3 | 0.111 |
LV ejection fraction (%) | 69 ± 5 | 68 ± 3 | 0.353 |
LV mass (g) | 87 ± 28 | 82 ± 19 | 0.739 |
Male (n = 51) | Female (n = 49) | |||||
---|---|---|---|---|---|---|
Silent myocardial ischemia (n = 7) | No silent myocardial ischemia (n = 44) |
p value
| Silent myocardial ischemia (n = 7) | No silent myocardial ischemia (n = 7) |
p value
| |
Age (years) | 59 | 55 | 0.339 | 58.5 | 61 | 0.585 |
Body-mass index (kg/m2) | 26.6 | 25.3 | 0.444 | 28.8 | 25.0 | 0.016* |
Waist-to-hip ratio | 0.90 | 0.92 | 0.968 | 0.93 | 0.88 | 0.042* |
Systolic blood pressure (mmHg) | 136 | 135 | 0.870 | 135 | 126 | 0.225 |
Diastolic blood pressure (mmHg) | 81 | 77 | 0.203 | 73 | 73 | 0.932 |
DM duration (years) | 6 | 6 | 0.725 | 12 | 5 | 0.183 |
Fasting glucose (mmol/L) | 6.4 | 6.4 | 0.367 | 5.5 | 6.4 | 0.121 |
Postprandial glucose (mmol/L) | 13.2 | 11.7 | 0.698 | 15.1 | 12.7 | 0.198 |
HbA1c (%) | 6.9 | 6.8 | 0.989 | 7.4 | 6.95 | 0.069 |
GA (%) | 15.6 | 15.5 | 0.942 | 18.6 | 15.5 | 0.096 |
Total cholesterol (mmol/L) | 3.9 | 4.2 | 0.511 | 4.4 | 4.3 | 0.51 |
LDL cholesterol (mmol/L) | 2.3 | 2.3 | 0.989 | 2.7 | 2.5 | 0.566 |
HDL cholesterol (mmol/L) | 1.1 | 1.1 | 0.799 | 1.2 | 1.1 | 0.424 |
Triglyceride (mmol/L) | 1.0 | 1.3 | 0.229 | 1.3 | 1.4 | 0.748 |
HOMA-IR | 2.7 | 2.6 | 1.000 | 5.2 | 3.0 | 0.586 |
Cardiovascular magnetic resonance | ||||||
EAT thickness (mm) | 11.9 | 12.5 | 0.947 | 14.1 | 11.5 | 0.031* |
OR | 95% CI for OR | Pvalue for EAT effect | |
---|---|---|---|
Unadjusted | 1.340 | 1.073 - 1.674 | 0.01** |
Adjusted for | |||
Age, gender | 1.334 | 1.062 - 1.677 | 0.013* |
Age, gender, BMI | 1.262 | 0.993 - 1.603 | 0.057 |
Age, gender, BMI, HbA1c, LDL, systotlic blood pressure, smoking history | 1.403 | 1.042 - 1.890 | 0.026* |