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Contribution of epicardial and abdominopelvic visceral adipose tissues in Chinese adults with impaired glucose regulation and diabetes

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Abstract

Aims

To quantify epicardial adipose tissue (EAT) and visceral adipose tissue (VAT) in Chinese adults with impaired glucose regulation (IGR) or diabetes and compare the contributions of EAT and VAT to the occurrence of IGR and diabetes with those of traditional obesity indices.

Methods

Cardiac and abdominopelvic noncontrast computed tomographic images of 668 individuals were used to measure EAT and VAT volume. Multivariable logistic regression and area under the receiver operating characteristic (ROC) curve were used to illustrate the contributions of these tissues.

Results

Patients with IGR or diabetes had larger EAT and VAT volumes than did the controls, and the VAT volume was significantly different between the IGR and diabetic groups. In multivariable models, higher EAT or VAT volume was positively associated with the presence of IGR and diabetes. After adjusting further for body mass index (BMI) and waist-to-hip ratio (WHR), a higher EAT volume was still positively associated with IGR (odds ratio (OR) = 1.46; 95% confidence interval (CI), 1.04–2.03), and a higher VAT volume was positively associated with IGR (OR = 1.86; 95% CI, 1.15–3.02) and diabetes (OR = 1.86; 95% CI, 1.16–2.99). The areas under the curve (AUCs) of the association of EAT (AUC = 0.751; 95% CI, 0.712–0.789) and VAT (AUC = 0.752; 95% CI, 0.713–0.792) with dysglycemia (IGR + diabetes) were significantly larger than those of the traditional obesity indices (all P < 0.05).

Conclusions

High EAT or VAT volume is positively associated with IGR and diabetes in Chinese adults. With a given WHR and BMI, such an association still exists to some extent. The correlation may be stronger than those of the traditional obesity indices.

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Abbreviations

ALP:

Alkaline phosphatase

ALT:

Alanine transaminase

ANOVA:

One-way analysis of variance

AST:

Plasma aspartate transaminase

AUC:

Area under the curve

BMI:

Body mass index

BUN:

Blood urea nitrogen

CI:

Confidence interval

CT:

Computed tomography

CVD:

Cardiovascular diseases

DBP:

Diastolic blood pressure

EAT:

Epicardial adipose tissue

EATHtR:

EAT volume-to-height ratio

ECG:

Electrocardiogram

FDR:

False discovery rate

FFA:

Free fatty acid

FPG:

Fasting plasma glucose

HbA1c:

Glycated hemoglobin A1c

HBP:

High blood pressure

HDL:

High-density lipoprotein

Hs-CRP:

High-sensitivity C-reactive protein

HU:

Hounsfield unit

IFG:

Impaired fasting glucose

IGR:

Impaired glucose regulation

IGT:

Impaired glucose tolerance

IR:

Insulin resistance

LDL:

Low-density lipoprotein

MetS:

Metabolic syndrome

OGTT:

75-g oral glucose tolerance test

OR:

Odds ratio

ROC:

Receiver operating characteristic (curve)

SAT:

Subcutaneous adipose tissue

SBP:

Systolic blood pressure

SD:

Standard deviation

TC:

Total cholesterol

TG:

Total triglyceride

VAT:

Visceral adipose tissue

VATHtR:

VAT volume-to-height ratio

VIF:

Variance inflation factor

WC:

Waist circumference

WHR:

Waist-to-hip ratio

WHtR:

Waist-to-height ratio

γ-GT:

Gamma-glutamyl transferase

2hPG:

2 h plasma glucose

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Acknowledgements

The authors are thankful to JY and XZ from Siemens Healthcare and other members who have participated in this project for their excellent technical support. Permissions were obtained from all contributors to this work. The study received no support in the form of funding.

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Author notes

  1. SiMin Wang and ZhenXun Wang have contributed equally to this work.

Authors and Affiliations

  1. Department of Radiology, Ruijin Hospital Affiliated with Shanghai Jiaotong University School of Medicine, No. 197 Ruijin 2nd Rd, Shanghai, 200025, People’s Republic of China

    SiMin Wang, ChiHua Chen, Lan Zhu, ShengJia Gu, Le Qin, FuHua Yan & WenJie Yang

  2. Division of Biostatistics, School of Public Health, The University of Minnesota, 420 Delaware St SE, Minneapolis, MN, 55455, USA

    ZhenXun Wang

  3. Department of Gastrointestinal Surgery, Ruijin Hospital Affiliated with Shanghai Jiaotong University School of Medicine, No. 197 Ruijin 2nd Rd, Shanghai, 200025, People’s Republic of China

    BoRan Pang

Authors
  1. SiMin Wang
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  4. Lan Zhu
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Correspondence to WenJie Yang.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The study was approved by the ethics committee of Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.

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All patients signed written informed consent forms before the initiation of the study procedure.

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Appendix: Subanalysis of males

Appendix: Subanalysis of males

See Tables 6, 7 and 8.

Table 6 Subanalysis of males of logistic regression of continuous adipose tissue indices
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Table 7 Subanalysis of males of logistic regression of categorical adipose tissue indices and traditional obesity indices
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Table 8 Subanalysis of males of the ROC curves of adipose tissues and traditional obesity indices
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Wang, S., Wang, Z., Chen, C. et al. Contribution of epicardial and abdominopelvic visceral adipose tissues in Chinese adults with impaired glucose regulation and diabetes. Acta Diabetol 56, 1061–1071 (2019). https://doi.org/10.1007/s00592-019-01348-z

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  • DOI: https://doi.org/10.1007/s00592-019-01348-z

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