Visceral abdominal adipose tissue and coronary atherosclerosis in asymptomatic diabetics

Abstract Background Visceral abdominal adipose tissue (VAT) may play an active role in the progression of coronary atherosclerosis. We examined the relation between VAT, non-alcoholic fatty liver disease and extent of coronary atheroma in patients with type 2 diabetes mellitus but no known coronary...

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Bibliographic Details
Published in:International journal of cardiology 2013-01, Vol.162 (3), p.184-188
Main Authors: Khashper, Alla, Gaspar, Tamar, Azencot, Mali, Dobrecky-Mery, Idit, Peled, Nathan, Lewis, Basil S, Halon, David A
Format: Article
Language:English
Subjects:
Abdominal Fat - pathology
Aged
Asymptomatic Diseases - epidemiology
Atherosclerosis (general aspects, experimental research)
Biological and medical sciences
Blood and lymphatic vessels
Cardiology. Vascular system
Cardiovascular
Cohort Studies
Computed tomography
Coronary Artery Disease - diagnosis
Coronary Artery Disease - epidemiology
Coronary atheroma
Coronary calcium
Coronary heart disease
Diabetes mellitus
Diabetes Mellitus - diagnosis
Diabetes Mellitus - epidemiology
Diabetes. Impaired glucose tolerance
Endocrine pancreas. Apud cells (diseases)
Endocrinopathies
Etiopathogenesis. Screening. Investigations. Target tissue resistance
Female
Heart
Humans
Intra-Abdominal Fat - pathology
Male
Medical sciences
Middle Aged
Visceral fat
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Summary:Abstract Background Visceral abdominal adipose tissue (VAT) may play an active role in the progression of coronary atherosclerosis. We examined the relation between VAT, non-alcoholic fatty liver disease and extent of coronary atheroma in patients with type 2 diabetes mellitus but no known coronary artery disease. Methods Coronary artery calcium and area, distribution and thickness of upper abdominal fat were measured in selected axial cross-sections from non-enhanced computed tomography (CT) scans of the chest. Coronary atheroma was assessed visually on a per vessel basis from 64 slice CT angiography using axial views and multi-format reconstructions. Fatty liver was diagnosed when liver density was < 40 Hounsfield units (HU) or ≥ 10 HU below spleen density. Results The area of VAT was increased in patients with versus without multi-vessel coronary artery plaque (237.0 ± 101.4 vs 179.2 ± 79.4 mm2 , p < 0.001). Waist circumference (101.6 ± 12.3 versus 95.3 ± 13.8 cm) and internal abdominal diameter (218.7 ± 33.0 vs 194.6 ± 25.7 mm) (both p < 0.001) were increased in patients with multi-vessel plaque whereas subcutaneous fat was unrelated to coronary plaque. Presence of fatty liver (93/318 patients, 29.2%) did not correlate with presence or extent of coronary plaque. The correlation of VAT with multi-vessel plaque although nominally independent of the metabolic syndrome (p = 0.04) was not independent of waist circumference. Conclusion In asymptomatic subjects with DM and no history of CAD area of VAT correlated with the presence and extent of coronary atheroma but as a risk predictor added little independent information to that obtained by more readily obtainable measures of adiposity—waist circumference and internal abdominal diameter.
ISSN:0167-5273
1874-1754
DOI:10.1016/j.ijcard.2011.05.059