Differential impact of visceral abdominal adipose tissue on vulnerable plaque detected by coroanry multi-detector row CT in patients with or without diabetes

Abstract

Background: Excess visceral abdominal adipose tissue (VAT) is strongly associated with atherosclerosis and cardiovascular disease, since VAT secrets many inflammatory cytokines. The significance of VAT in patients with or without DM has not fully investigated. The aim of this study was to investigate the association between VAT and the presence and characteristics of coronary artery plaques in the patients with or without DM using 64 slice computed tomography angiography. Methods and results: We retrospectively evaluated 456 consecutive patients (57% male, age 64±14 years) who were suspected CAD with MDCT. 71 (16%) patients had vulnerable plaque (VP) with low density area 60cm2 and ≤106cm2, T3 n=111 VAT >106cm2 and DM group: T1, n=40, ≤87cm2, T2, n=41, >87cm2 and ≤130cm2, T3, n=41, >130cm2) (Table). In non-DM patients, higher age, male, current smoking history, lower HDL cholesterol and VAT areas were significantly correlated with of VP. Multivariate analysis in no-DM patients revealed higher VAT area was independently associated with VP (odds ratio [OR]: 3.84; 95% confidence interval [CI]: 1.04-14.14,p=0.04). However, in DM patients, no association between VAT area and VP was found. View this table: Table 1. Multivariate analysis for VP Conclusion: VAT was significantly associated with VP independent of traditional measures of CAD in only non-DM patients. Risk assessment of cardiovascular disease could be improved by combining VAT measurements and traditional risk factors in non DM patients.