Abstract
Background: Although early detection of coronary artery disease (CAD) can reduce mortality, CAD in diabetic patients rarely presents typical symptoms and it is more difficult to detect. Recently, quantification of epicardial adipose tissue (EAT), which is thought to be an ectopic adipose tissue, has been developed as a means of detecting possible CAD. The purpose of this study was to investigate the relationship between EAT thickness measured by echocardiography and presence of CAD in patients with type 2 diabetes.
Subjects and Methods: We enrolled 182 patients with type 2 diabetes (mean age 67±11 yrs; 128 males, 54 females) who underwent coronary angiography between June 2011 and June 2016 at our hospital. We measured the EAT thickness in the anterior interventricular groove (EAT-AIG) by echocardiography using a high-frequency linear probe. Subjects were divided into two groups; with and without significant coronary stenosis (CAD group: 108 patients and non-CAD group: 74 patients) based on coronary angiography.
Results and Discussion: Forty-seven patients (44%) in the CAD group were asymptomatic. EAT-AIG thickness was significantly greater in the CAD group than of the non-CAD group (8.3±2.8 vs. 5.7±2.1 mm, p＜0.001). Through receiver operating characteristic analysis, EAT-AIG thickness had high c-statics (AUC: 0.82, p＜0.001) after adjustment for conventional risk factors (age, male gender, body mass index, hypertension, dyslipidemia, and smoking). EAT-AIG thickness had incremental diagnostic value over other conventional risk factors (AUC: 0.82 vs. 0.65, comparison p＜0.001) regardless of the presence of symptoms.
Conclusion: Echocardiographic EAT-AIG thickness was greater in the CAD group than in the non-CAD group. This non-invasive index may be a useful diagnostic marker for detecting CAD in patients with type 2 diabetes.
