Epicardial Adipose Tissue Thickness as a Reliable Marker of Increased Cardiovascular Risk in Patients With Type 2 Diabetes Mellitus

Background: Epicardial adipose tissue (EAT) is a distinct visceral adipose tissue that is present in between the visceral pericardium and myocardium, in which the coronary arteries are lodged. This tissue releases several inflammatory and atherogenic mediators which lead to the initiation and/or progression of coronary atherosclerosis and its thickness is related to the presence and severity of atherosclerotic coronary artery disease (CAD). In this study, we aimed to evaluate the EAT thickness in type 2 diabetes mellitus (T2DM) patients by non-contrast computed tomography (NCCT) of the chest and to correlate its value with HbA1c levels, duration of T2DM and carotid intima-media thickness (CIMT). Methods: This was a cross-sectional study comprising of 40 patients with T2DM who underwent NCCT of chest and ultrasonographic estimation of CIMT. Ten individuals with equivalent age and sex were included as controls, in whom NCCT of chest was done for other purposes. All the individuals underwent thorough history, clinical examination and certain investigations based on a predesigned proforma. Results: The EAT thickness was significantly increased in patients with T2DM as compared to controls (8.7 ± 2.94 mm vs. 3.48 ± 0.99 mm, P < 0.001) and also strongly correlated with duration of diabetes (P = 0.02), HbA1c (P  is less than or equal to 0.001), total cholesterol (P is less than or equal 0.001), serum triglyceride levels (P is less than or equal 0.001) and body mass index (BMI) (P is less than or equal 0.001). Conclusion: EAT thickness can be regarded as a sensitive and non-invasive marker for risk stratification of CAD. J Endocrinol Metab. 2020;10(6):173-181 doi: https://doi.org/10.14740/jem710