Epicardial adipose tissue thickness is an indicator for coronary artery stenosis in asymptomatic type 2 diabetic patients: its assessment by cardiac magnetic resonance
Epicardial adipose tissue thickness is an indicator for coronary artery stenosis in asymptomatic type 2 diabetic patients: its assessment by cardiac magnetic resonance
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DOI：
10.1186/1475-2840-11-83
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发表时间：
2012-07-18
影响因子：
9.3
通讯作者：
Kim, Young Jin
中科院分区：
文献类型：
--
作者：
Kim, Hyun Min;Kim, Kwang Joon;Kim, Young Jin
背景：我们使用心血管磁共振 (CMR) 来研究无症状 2 型糖尿病患者的心外膜脂肪组织 (EAT) 厚度与无症状心肌缺血以及冠状动脉狭窄之间的关联。方法：该研究包括 100 名 2 型糖尿病受试者（51 名男性和 49 名女性；平均年龄：56 +/- 7 岁）。通过 CMR 确定的无症状心肌缺血被定义为诱导性缺血或心肌梗塞的证据。以血管直径信号减少或狭窄≥50%作为冠状动脉磁共振（MR）血管造影显着冠状动脉狭窄的标准。结果：EAT厚度与体重指数（BMI）、腰臀比、收缩压、餐后血糖、空腹/餐后甘油三酯（TG）、血清呈正相关。 糖化血红蛋白 (HbA1c) 水平和胰岛素抵抗稳态模型评估 (HOMA-IR) 评分。 24 例患者发现明显冠状动脉狭窄，14 例 CMR 患者有无症状心肌缺血（1 例无症状心肌梗死，11 例诱导性缺血，2 例两者都有）。冠状动脉狭窄患者的 EAT 厚度更大（13.0 +/- 2.6 mm 与 11.5 +/- 2.1 mm，p = 0.01），但 CMR 图像上有或没有无症状心肌缺血的受试者之间没有差异（12.8 +/- 2.1 与 11.7 +/- 2.3 mm，p = 0.11）。多因素logistic回归分析表明，调整传统危险因素后，EAT厚度是显着冠状动脉狭窄的独立危险因素（OR 1.403，p = 0.026）。结论：CMR评估的EAT厚度增加是无症状2型糖尿病显着冠状动脉狭窄的独立危险因素。然而，EAT 厚度与无症状心肌缺血无关。
Background: We used cardiovascular magnetic resonance (CMR) to investigate the association between epicardial adipose tissue (EAT) thickness and silent myocardial ischemia, as well as coronary artery stenosis, in asymptomatic type 2 diabetic patients.Methods: The study included 100 type 2 diabetic subjects (51 male and 49 female; mean age: 56 +/- 7 years). Silent myocardial ischemia, as determined by CMR, was defined as evidence of inducible ischemia or myocardial infarction. Signal reduction or stenosis of >= 50% in the vessel diameter was used as the criteria for significant coronary artery stenosis on coronary magnetic resonance (MR) angiography.Results: EAT thickness was positively correlated with body mass index (BMI), waist-to-hip ratio, systolic blood pressure, postprandial glucose, fasting/postprandial triglyceride (TG), serum glycated hemoglobin (HbA1c) level, and homeostasis model assessment of insulin resistance (HOMA-IR) score. Significant coronary artery stenosis was found in 24 patients, while 14 patients had silent myocardial ischemia in CMR (1 with silent myocardial infarction, 11 with inducible ischemia, and 2 with both). EAT thickness was greater in patients who had coronary artery stenosis (13.0 +/- 2.6 mm vs. 11.5 +/- 2.1 mm, p = 0.01), but did not differ between the subjects with or without silent myocardial ischemia on CMR images (12.8 +/- 2.1 vs. 11.7 +/- 2.3 mm, p = 0.11). Multivariate logistic regression analysis indicated that EAT thickness was an independent indicator for significant coronary artery stenosis after adjusting for traditional risk factors (OR 1.403, p = 0.026).Conclusions: Increased EAT thickness assessed by CMR is an independent risk factor for significant coronary artery stenosis in asymptomatic type 2 diabetes. However, EAT thickness was not associated with silent myocardial ischemia.