High pericardial and peri-aortic adipose tissue burden in pre-diabetic and diabetic subjects.
BACKGROUND
Central obesity in relation to insulin resistance is strongly linked to the development of type 2 diabetes. However, data regarding the association between pericardial and peri-aortic adiposity, a potential estimate of visceral adipose tissue burden, and pre-diabetes status remains unclear.The aim of this study was to examine whether the degree of pericardial and thoracic peri-aortic adipose tissue, when quantified by multi-detector computed tomography (MDCT), differs significantly in a normal, pre-diabetic, and overtly diabetic population.


METHODS
We studied 562 consecutive subjects including 357 healthy, 155 pre-diabetic, and 50 diabetic patients selected from participants who underwent annual health surveys in Taiwan. Pre-diabetes status was defined by impaired fasting glucose or impaired glucose intolerance according to American Diabetes Association guidelines. Pericardial (PCF) and thoracic peri-aortic (TAT) adipose tissue burden was assessed using a non-contrast 16-slice multi-detector computed tomography (MDCT) dataset with off-line measurement (Aquarius 3D Workstation, TeraRecon, San Mateo, CA, USA). Body fat composition, serum high-sensitivity C-reactive protein (hs-CRP) level and insulin resistance (HOMA-IR) were also assessed.


RESULTS
Patients with diabetes and pre-diabetes had greater volume of PCF (89 ± 24.6, 85.3 ± 28.7 & 67.6 ± 26.7 ml, p < 0.001) as well as larger TAT (9.6 ± 3.1 ml vs 8.8 ± 4.2 & 6.6 ± 3.5 ml, respectively, p < 0.001) when compared to the normal group, although there were no significant differences in adiposity between the diabetic and pre-diabetic groups. For those without established diabetes in our study, increasing TAT burden, but not PCF, appear to correlate with insulin resistance (HOMA-IR) and hs-CRP in the multivariable models.


CONCLUSIONS
Pre-diabetic and diabetic subjects, compared to normoglycemia, were associated with significantly higher pericardial and peri-aortic adipose tissue burden. In addition, visceral fat accumulation adjacent to the thoracic aorta seemed to exert a significant impact on insulin resistance and systemic inflammation.
Fei-Shih
FS
Yang
Chun-Ho
CH
Yun
Tung-Hsin
TH
Wu
Ya-Ching
YC
Hsieh
Hiram G
HG
Bezerra
Chuan-Chuan
CC
Liu
Yih-Jer
YJ
Wu
Jen-Yuan
JY
Kuo
Graduate Institute of Health Care Organization Administration, College of Public Health National Taiwan University, Taipei, Taiwan. jotaro3791@gmail.com.
Chung-Lieh
CL
Hung
Charles Jia-Yin
CJ
Hou
Hung-I
HI
Yeh
Jason Jeun-Shenn
JJ
Lee
Bernard E
BE
Bulwer
Ricardo C
RC
Cury
D000273:Adipose Tissue / Q000473:pathology*; D000328:Adult; D001013:Aorta, Thoracic / Q000473:pathology*; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D005951:Glucose Tolerance Test / Q000639:trends; D006306:Health Surveys / Q000639:trends*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010496:Pericardium / Q000473:pathology*; D011236:Prediabetic State / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology; D013624:Taiwan / Q000453:epidemiology