Abstract
BackgroundEpicardial fat tissue (EFT) is the visceral fat distributed along the coronary arteries between the pericardium and the myocardium. Increases in EFT are closely related to the occurrence of diabetes mellitus (DM) and cardiovascular disease. To further understand the link between EFT and DM, we conducted a meta-analysis of the relevant literature.MethodsWe systematically searched electronic databases for studies on EFT performed in DM patients and published up to 30 September 2018. We included data on EFT in a DM patient group and a non-DM control group. We then assessed the effect of DM on EFT by meta-analysis and trial sequential analysis (TSA). All statistical analyses were performed using Stata 12.0 and TSA software.ResultsA total of 13 studies (n = 1102 patients) were included in the final analysis. Compared with the control group, DM patients had significantly higher EFT (SMD: 1.23; 95% CI 0.98, 1.48; P = 0.000; TSA-adjusted 95% CI 0.91, 2.13; P < 0.0001). The TSA indicated that the available samples were sufficient and confirmed that firm evidence was reached. According to the regression analysis and subgroup analyses, DM typing, EFT ultrasound measurements, total cholesterol (TC) and triglyceride (TG) levels were confounding factors that significantly affected our results.ConclusionsOur meta-analysis suggests that the amount of EFT is significantly higher in DM patients than in non-DM patients.
Highlights
Epicardial fat tissue (EFT) is the visceral fat distributed along the coronary arteries between the pericardium and the myocardium
Recent studies have confirmed that EFT is associated with obesity, fasting blood glucose levels, insulin resistance, and adiponectin in patients with type 2 diabetes mellitus (T2DM), and an increase in EFT was observed in patients with type 1 diabetes mellitus (T1DM) and T2DM [18,19,20,21,22]
EFT thickness was measured by echocardiography in 11 studies [20, 21, 27,28,29,30, 32, 33, 35,36,37], and the volume of EFT was measured by computed tomography (CT) in 2 studies [31,32,33,34]
Summary
Epicardial fat tissue (EFT) is the visceral fat distributed along the coronary arteries between the pericardium and the myocardium. Accumulated visceral fat is a risk factor for insulin resistance, which can reduce insulin sensitivity, increase the Epicardial fat tissue (EFT) is a visceral adipose tissue that surrounds the myocardium and pericardium. It is one of the visceral fat stores in the body. Previous studies have suggested that measurements of EFT are a substitute for visceral fat [8, 9] EFT can secrete inflammatory factors, such as TNF-alpha, IL-6, adipocytokines, and leptin, via paracrine or endocrine activities [9, 10] to locally regulate the myocardium and coronary artery function and regulate lipid and energy homeostasis in vivo. Recent studies have confirmed that EFT is associated with obesity, fasting blood glucose levels, insulin resistance, and adiponectin in patients with T2DM, and an increase in EFT was observed in patients with T1DM and T2DM [18,19,20,21,22]
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