Relationship between epicardial adipose tissue and body muscle-to-fat ratio in patients with type 2 diabetes mellitus

Type 2 Diabetes mellitus (T2DM) is shown as an important risk factor for the development of cardiovascular diseases worldwide. Epicardial adipose tissue (EAT) has been associated with cardiovascular diseases. The body muscle-to-fat ratio measured by bioelectric impedance (BIA) is associated with cardiac dysfunction. In this study, we aimed to evaluate the relationship between EAT and body muscle-to-fat ratio in T2DM patients. The 125 consecutive T2DM patients and 46 healty volunteers included in the study. EAT was measured by using transthorasic echocardiograph (TTE). Data were obtained BIA analysis in all patient. The muscle-to-fat ratio measured by BIA and EAT was compared between the two groups. There was a significant difference between the groups in terms of waist circumference (WC), fat mass, fat mass ratio, muscle mass and muscle-to-fat ratio. E (p

___

1. Tian S, Xu Y. Association of sarcopenic obesity with the risk of all-cause mortality: a meta-analysis of prospective cohort studies. Geriatr Gerontol Int. 2016;16:155–66.

2. Xiaoyou Su, Jing Xu, Chao Zheng. The relationship between non-alcoholic fatty liver and skeletal muscle mass to visceral fat area ratio in women with type 2 diabetes. BMC Endocrine Disorders. 2019;19:76.

3. Iacobellis G. Local and systemic effects of the multifaceted epicar-dial adipose tissue depot. Nat Rev Endocrinol. 2015;11:363-71.

4. Sacks HS, Fain JN. Human epicardial adipose tissue: a review. Am Heart J. 2007;153:907–17.

5. Yudkin JS, Stehouwer CD, Emeis JJ, et al. C-reactive protein in healthy subjects: associations with obesity, insulin resistance, and en-dothelial dysfunction: a potential role for cytokines originating from adipose tissue? Arterioscler Thromb Vasc Biol. 1999;19:972–8.

6. Iacobellis G, Corradi D, Sharma AM. Epicardial adipose tissue: an-atomic, biomolecular and clinical relationships with the heart. Nat Rev Cardiol. 2005;2:536-43.

7. Lukaski HC, Johnson PE, Bolonchuk WW, et al. Assessment of fat-free mass using bioelectrical impedance measurements of the human body. Am J Clin Nutr. 1985;41:810–7.

8. Qian Wang, Dongmei Zheng, Jia Liu, et al. Skeletal muscle mass to visceral fat area ratio is an important determinant associated with type 2 diabetes and metabolic syndrome Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy. 2019:12:1399-407.

9. American Diabetes Association Diagnosis and classification of diabetes mellitus. Diabetes Care. 2014;37:81-90.

10. Dereli S, Bayramoğlu A, Yontar OC, et al. Epicardial fat thickness: A new predictor of successful electrical cardioversion and atrialfibrillation recurrence. Echocardiography. 2018;35:1926-31.

11. Rader DJ. Effect of insulin resistance, dyslipidemia, and intra-abdominal adiposity on the development of cardiovascular disease and diabetes mellitus. Am J Med 2007;120:12-8.

12. Doyle SL, Bennett AM, Donohoe CL, et al. Establishing computed tomography-defined visceral fat area thresholds for use in obesity-related cancer research. Nutr Res. 2013;33:171-9.

13. Shuster A, Patlas M, Pinthus JH, et al. The clinical impor- tance of visceral adiposity: a critical review of methods for visceral adipose tissue analysis. Br J Radiol. 2012;85:1–10.

14. Amato MC, Giordano C, Galia M, et al. AlkaMeSy Study Group. Visceral adiposity index: A reliable indicator of visceral fat function associated with cardiometabolic risk. Diabetes Care. 2010;33:920-2.

15. Kurinami N, Sugiyama S, Yoshida A, et al. Correlation of body muscle/ fat ratio with insulinsensitivity using hyperinsulinemic-euglycemic clamp in treatment-naïve type 2 diabetes mellitus. Diabetes Res Clin Pract. 2016;120:65-72.

16. Kurinami N, Sugiyama S, Yoshida A, et al. Body muscle-to-fat ratio genderspecific cut-off values for impaired insulin sensitivity in patients with treatment-naïve type 2 diabetes mellitus. Endocrine 2019;66:503-8.

17. From AM, Scott CG, Chen HH. The development of heart failure in patients with diabetes mellitus and pre-clinical diastolic dysfunction: a populationbased study. J Am Coll Cardiol 2010;55:300-5.

18. Poirier P, Bogaty P, Garneau C, et al. Diastolic dysfunction in normotensive men with well-controlled type 2 diabetes: importance of maneuvers in echocardiographic screening for preclinical diabetic cardiomyopathy. Diabetes Care. 2001;24:5-10.

19. Galderisi M. Diastolic dysfunction and diabetic cardiomyopathy: evaluation by Doppler echocardiography. J Am Coll Cardiol 2006;48:1548-51.

20. Ernande L, Bergerot C, Rietzschel ER, et al. Diastolic dysfunction in patients with type 2 diabetes mellitus: is it really the first marker of diabetic cardiomyopathy? J Am Soc Echocardiogr. 2011;24:1268-75.

21. Al Chekakie MO, Welles CC, Metoyer R, et al. Pericardial fat is independently associated with human atrial fibrillation. J Am Coll Cardiol. 2010;56:784–8.

22. Nakanishi K, Fukuda S, Tanaka A, et al. Peri-atrial epicardial adipose tissue is associated with new-onset nonvalvular atrial fibrillation. Circ J. 2012;76:2748–54.

23. Wong CX, Abed HS, Molaee P, et al. Pericardial fat is associated with atrial fibrillation severity and ablation outcome. J Am Coll Cardiol. 2011;57:1745- 51.

24. Baloglu I, Turkmen K, Selcuk NY, et al. The Relationship Between Visceral Adiposity Index and Epicardial Adipose Tissue in Patients with Type 2 Diabetes Mellitus. Exp Clin Endocrinol Diabetes. 2019 May 6.

25. Silaghi A, Piercecchi-Marti MD, Grino M, et al. Epicardial adipose tissue extent: relationship with age, body fat distribution, and coronaropathy. Obesity (Silver Spring). 2008;16:2424-30.

26. Mazzoccoli G , Dagostino MP, Greco A. Age-related changes of epicardial fat thickness. Biomedicine & Preventive Nutrition. 2012;2:38-41.

27. Hatani Y, Tanaka H, Mochizuki Y, et al. Association of body fat mass with left ventricular longitudinal myocardial systolic function in type 2 diabetes mellitus. Journal of Cardiology. 2020;75:189-95.

28. Börekçi A, Gür M, Şeker T, et al. Epicardial fat thickness as associated with left ventricular myocardial performance in patients with newly diagnosed hypertension. Turk Kardiyol Dern Ars. 2015;43:705-13.