Epicardial adipose tissue is a predictor of decreased kidney function and coronary artery calcification in youth- and early adult onset type 2 diabetes mellitus

  • M. ReinhardtEmail author
  • T. R. Cushman
  • M. S. Thearle
  • J. Krakoff
Original Article



To examine the association of epicardial and pericardial fat volume (EFV, PFV) with cardiovascular risk factors and kidney function in Native Americans of southwestern heritage with youth and early adult onset type 2 diabetes mellitus (T2DM) versus healthy controls.


Using computed tomography, we quantified EFV and PFV in 149 Native Americans (92 women, 57 men), 95 of which had T2DM (38 diagnosed prior to age 20 years). Duration of T2DM, mean carotid arterial mass (AM), coronary artery calcification (CAC), IL-6, and estimated glomerular filtration rate eGFRcr(CKD-EPI) were measured.


EFV and PFV were associated with BMI (r = 0.37, p < 0.0001; r = 0.26, p = 0.001) and did not differ between onset age-groups and controls (p > 0.05). EFV was associated with AM only in controls (r = 0.51, p < 0.0001). After adjustment for BMI, T2DM duration, HbA1C, age, and sex, EFV was a predictor of CAC and IL-6 concentrations in early adult onset T2DM (β = 0.05 ± 0.02 cm3, p = 0.03; β = 0.05 ± 0.01 pg/ml/cm3, p = 0.002). EFV and PFV were independent predictors of reduced eGFRcr(CKD-EPI) in the youth onset T2DM group (β = −0.3 ± 0.08 ml/min/cm3, p = 0.001; β = −0.25 ± 0.05 ml/min/cm3, p < 0.0001).


Epicardial fat volume may be a risk factor for heart disease in individuals with early adult onset T2DM and a predictor of decreased kidney function in individuals with youth onset T2DM.


Epicardial adipose tissue Pericardial adipose tissue Type 2 diabetes mellitus Kidney function Coronary calcification 


Authors contributions

MR wrote the manuscript. MR and TC analyzed the data. MR, MST, TC, and JK designed the study. MR and TC quantified epicardial and pericardial adipose tissue. MR, TC, MST, and JK contributed to the interpretations of findings and commented on and edited the drafts. JK is the guarantor of this work and, as such, had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.


This research was supported by the Intramural Research Program of the National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases.

Compliance with ethical standards

Conflict of interest

The authors declare no conflict of interest.

Ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Research involving human participants and/or animals

This article does not contain any studies with animals performed by any of the authors. This study was approved by the NIDDK Institutional Review Board.

Informed consent

All participants gave written and verbal informed consent for the studies.


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Copyright information

© This is a U.S. government work and its text is not subject to copyright protection in the United States; however, its text may be subject to foreign copyright protection 2019

Authors and Affiliations

  • M. Reinhardt
    • 1
    • 2
    Email author
  • T. R. Cushman
    • 1
  • M. S. Thearle
    • 1
  • J. Krakoff
    • 1
  1. 1.Obesity and Diabetes Clinical Research Section, Department of Health and Human Services, Phoenix Epidemiology and Clinical Research Branch National Institute of Diabetes and Digestive and Kidney DiseasesNational Institutes of HealthPhoenixUSA
  2. 2.Department of Diagnostic and Interventional RadiologyUniversity of Leipzig Medical CenterLeipzigGermany

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