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Thoracic periaortic adipose tissue in relation to cardiovascular risk in type 2 diabetes mellitus

Steht das thorakale periaortale Fettgewebe mit dem kardiovaskulären Risiko bei Patienten mit Diabetes mellitus Typ 2 in Zusammenhang?

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Summary

Objective

To evaluate thoracic periaortic adipose tissue (TAT) burden in patients with type 2 diabetes mellitus (DM) in comparison with controls and in relation to cardiovascular risk factors.

Methods

A total of 93 patients with type 2 DM (mean (standard deviation; SD) age: 56.7 (11.2) years, 71.0 % were men) and 85 nondiabetic control subjects (mean (SD) age: 54.6 (10.9) years, 58.8 % were men) who were admitted to Mevlana University hospital between January 2011 and June 2013 and underwent multidetector computed tomography for any reason were included in this retrospective cohort study. Patient and control groups were compared in terms of demographic characteristics, anthropometrics, and laboratory findings. TAT volume was evaluated in both groups, while correlates of TAT were determined via linear regression analysis among patients.

Results

In patients with type 2 DM, TAT volume (40.1 (23.9) versus 16.9 (7.7) cm3, p < 0.001), fasting blood glucose (p < 0.001), total cholesterol (p < 0.001), triglyceride (p = 0.017), and low-density lipoprotein (LDL) cholesterol (p = 0.034) levels were significantly higher compared with the control group. Strong positive correlation of TAT was noted with body mass index (r = 0.339, p = 0.001) and serum levels for fasting blood glucose (r = 0.343, p < 0.001), hemoglobin A1c (HbA1c; r = 0.615, p < 0.001), total cholesterol (r = 0.269, p = 0.009), and LDL cholesterol (r = 0.258, p = 0.013). In stepwise regression analysis, Hba1c emerged as a significant predictor of TAT (b = 0.610, p < 0.001), contributing to 19 % of its variability.

Conclusion

In conclusion, our findings indicate significantly higher values for TAT in diabetics than controls, being associated positively with body weight, poor glycemic control, and dyslipidemia and strongly predicted by HbA1c levels in diabetic patients, while not differing with respect to gender, smoking status, and concomitant hypertension.

Zusammenfassung

Ziel

Auswertung des Ausmaßes von thorakalem periaortalem Fettgewebe (TPF) bei Patienten mit Typ 2 Diabetes mellitus im Vergleich zu Kontrollen und im Zusammenhang mit kardiovaskulären Risikofaktoren.

Methoden

Insgesamt wurden 93 Patienten mit Typ 2 Diabetes mellitus (Mittleres (SD) Alter 56,7 (11,2) Jahre, 71,0 % Männer) und 85 Kontrollpersonen ohne Diabetes mellitus (Mittleres (SD) Alter: 54,6 (10,9) Jahre, 58,8 % Männer), die dem Mevlana Universitäts-Spital zwischen Jänner 2011 und Juni 2013 zugewiesen worden waren und bei denen, aus welchem Grund auch immer, eine Multidetektor Computer Tomographie durchgeführt worden war, in diese retrospektive Kohortenstudie aufgenommen. Die Patienten und Kontrollpersonen wurden bezüglich demographischer und anthropometrischer Charakteristika, sowie Laborergebnissen verglichen. Das TPF wurde bei beiden Gruppen erhoben und mögliche Korrelationen mittels linearer Regressions Analyse errechnet.

Ergebnisse

Bei Patienten mit Typ 2 Diabetes mellitus. war das TPF Volumen 40,1 (23,9) cm3 vs. 16,9 (7,7) cm3, p < 0,001), der Nüchternblutzucker (p < 0,001), das Gesamt-Cholesterin (p < 0,001), die Triglyceride (p = 0,017), und das LDL-Cholesterin (p = 0,034) im Vergleich zur Kontrolle signifikant höher. Das TPF war besonders positiv mit dem Body Mass Index (r = 0,339; p = 0,001), dem Nüchternblutzucker (r = 0,343; p < 0,001), dem Hämoglobin A1c (HbA1c) (r = 0,615; p < 0,001), dem Gesamt Cholesterin (r = 0,269; p = 0,009) und dem LDL-Cholesterin (r = 0,258; p = 0,013) korreliert. Die stufenweise Regressionsanalyse ergab, dass das HbA1c ein signifikanter Prädiktor des TPF (b = 0,610, p < 0,001) war, und 19 % zu seiner Variabilität beitrug.

Schlussfolgerung

Unsere Ergebnisse zeigen, dass das TPF bei Patienten mit Typ Diabetes mellitus signifikant höher ist als bei Kontrollen ohne Diabetes mellitus. Das TPF ist signifikant positiv mit dem Körpergewicht und mit schlechter Kontrolle der Glykämie und Dyslipidämie korreliert und kann bei Diabetikern deutlich vom HbA1c vorhergesagt werden. Es besteht keine Korrelation zum Geschlecht, Raucherstatus und eventueller begleitender Hypertonie.

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Authors and Affiliations

  1. Department of Internal Medicine, Mevlana University Faculty of Medicine, Konya, Turkey

    Ömer Akyürek MD

  2. Department of Radiological, Mevlana University Faculty of Medicine, Konya, Turkey

    Duran Efe MD

  3. Department of Cardiology, Mevlana University Faculty of Medicine, Konya, Turkey

    Zeynettin Kaya MD

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  2. Duran Efe MD
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  3. Zeynettin Kaya MD
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Correspondence to Ömer Akyürek MD.

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Akyürek, Ö., Efe, D. & Kaya, Z. Thoracic periaortic adipose tissue in relation to cardiovascular risk in type 2 diabetes mellitus. Wien Klin Wochenschr 126, 767–773 (2014). https://doi.org/10.1007/s00508-014-0611-8

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