title: Visceral abdominal adipose tissue and coronary atherosclerosis in asymptomatic diabetics.
abstract: BACKGROUND
  Visceral abdominal adipose tissue (VAT) may play an active role in the progression of coronary atherosclerosis. We examined the relation between VAT, non-alcoholic fatty liver disease and extent of coronary atheroma in patients with type 2 diabetes mellitus but no known coronary artery disease.
  
  
  METHODS
  Coronary artery calcium and area, distribution and thickness of upper abdominal fat were measured in selected axial cross-sections from non-enhanced computed tomography (CT) scans of the chest. Coronary atheroma was assessed visually on a per vessel basis from 64 slice CT angiography using axial views and multi-format reconstructions. Fatty liver was diagnosed when liver density was <40 Hounsfield units (HU) or ≥10 HU below spleen density.
  
  
  RESULTS
  The area of VAT was increased in patients with versus without multi-vessel coronary artery plaque (237.0 ± 101.4 vs 179.2 ± 79.4 mm(2), p<0.001). Waist circumference (101.6 ± 12.3 versus 95.3 ± 13.8 cm) and internal abdominal diameter (218.7 ± 33.0 vs 194.6 ± 25.7 mm) (both p<0.001) were increased in patients with multi-vessel plaque whereas subcutaneous fat was unrelated to coronary plaque. Presence of fatty liver (93/318 patients, 29.2%) did not correlate with presence or extent of coronary plaque. The correlation of VAT with multi-vessel plaque although nominally independent of the metabolic syndrome (p=0.04) was not independent of waist circumference.
  
  
  CONCLUSIONS
  In asymptomatic subjects with DM and no history of CAD area of VAT correlated with the presence and extent of coronary atheroma but as a risk predictor added little independent information to that obtained by more readily obtainable measures of adiposity-waist circumference and internal abdominal diameter.
authors.affiliation: Department of Radiology, Lady Davis Carmel Medical Center and the Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
authors.forename: Alla
authors.initials: A
authors.lastname: Khashper
authors.forename: Tamar
authors.initials: T
authors.lastname: Gaspar
authors.forename: Mali
authors.initials: M
authors.lastname: Azencot
authors.forename: Idit
authors.initials: I
authors.lastname: Dobrecky-Mery
authors.forename: Nathan
authors.initials: N
authors.lastname: Peled
authors.forename: Basil S
authors.initials: BS
authors.lastname: Lewis
authors.forename: David A
authors.initials: DA
authors.lastname: Halon
mesh_terms: D050153:Abdominal Fat / Q000473:pathology; D000368:Aged; D058070:Asymptomatic Diseases / Q000453:epidemiology*; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000453:epidemiology*; D003920:Diabetes Mellitus / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat / Q000473:pathology*; D008297:Male; D008875:Middle Aged