Comparison of Epicardial Adipose Tissue Volume and Coronary Artery Disease Severity in Asymptomatic Adults With Versus Without Diabetes Mellitus

Epicardial adipose tissue (EAT) has been shown to have important effects on the development of coronary artery disease (CAD) via local paracrine influences on the vascular bed. We compared a cohort of asymptomatic patients with Type II Diabetes (DM) without known CAD to an age and gender matched group of asymptomatic patients without DM from the CTRAD study in which patients underwent a cardiac computed tomography angiogram (CTA), for early detection of CAD. Mean EAT volumes of 118.6 ± 43.0 and 70.0 ± 44.0 cm(3) were found in the DM and non-DM groups respectively. When stratified by presence and severity of CAD, it was found that in the DM (p=0.003) and non-DM groups (p<0.001) there was a statistically significant increase in EAT volume as the patients were found to have increasingly severe CAD. After adjusting for age, race, gender, DM, hypertension, insulin use, BMI, and coronary artery calcium (CAC) score, the presence of >120 cm(3) of EAT was found to be highly correlated with the presence of significant CAD (Adjusted Odds Ratio 4.47, 95% CI (1.35–14.82)). We found that not only is EAT volume an independent predictor of CAD, but that an increasing volume of EAT predicted increasing severity of CAD even after adjustment for CAC score

Perivascular Fat and its Role in Vascular Disease, Insulin Resistance and Diabetes

Perivascular adipose tissue is a visceral fat depot with an anatomical and functional contiguity to the vasculature system. Recent evidence suggests that perivascular adipose tissue could mechanically and functionally affect the vasculature, thereby possibly playing a role in adiposity-related atherosclerosis. Experimental and clinical observations suggest both favorable and unfavorable effects of perivascular fat. This review focuses on the emerging physiological and pathophysiological aspects of the perivascular fat and its role in vascular disease, insulin resistance and diabetes