P5299Epicardial obesity as a significant predictor of leptino and insulin resistance

Abstract

Abstract Leptino (LR) and insulin resistance (IR) are significant predictors of atherosclerosis, thrombosis, type 2 diabetes. The effect of epicardial obesity (EO) (as a type of visceral obesity) on the formation of LR and IR is studied. Objective To study the effect of EO on the formation of LR and IR among men with arterial hypertension (AH). Materials and methods The study included 130 men 49.5±4.3 years old, with AH of 1–3 degrees and the absence of clinical manifestations of coronary heart disease and atherosclerosis of other localizations, type 2 diabetes with a BMI of 20–35 kg /m2 and abdominal obesity according to WC ≥94 cm. Patients were divided into two groups depending on the thickness of epicardial adipose tissue (EAT), measured behind the free wall of the right ventricle by echocardiography. Group 1 consisted of 60 patients with epicardial obesity (EAT ≥7 mm), group 2 included 70 patients without epicardial obesity (EAT <7 mm). All subjects assessed indicators of LR and IR: measured levels of serum leptin (SL), soluble receptors for leptin (SLR), free leptin index (FLI), calculated as the ratio SL/SLR (as the only currently existing marker LR); IR was estimated by calculating the HOMA-IR index. IR was diagnosed with the generally accepted HOMA-IR index >2.7. Results When comparing LR indices in the studied groups, higher average values of SL, FLI were observed in the group with EO (EAT ≥7 mm) than in the group without EO (EAT <7 mm): (SL = 32.16 ng/ml (26.7; 37.62) versus SL = 14.92 ng/ml (11.62; 18.22), p=0.01, respectively); (FLI = 1.67 (0.47; 2.87) versus FLI = 0.37 (0.28; 0.46), p=0.01, respectively). Also in the EO group, higher indices of the HOMA-IR index were observed compared with the group without EO: (2.16 (1.62; 2.66) versus 1.35 (1.06; 1.64), p=0,01, respectively). When conducting the correlation analysis between FLI (as a marker of LR) and various obesity indicators (BMI, WC, EO) in the studied groups, a significant positive correlation relationship between FLI and EO was found in both the first and second groups (r=0.67, p=0.01; r=0.62, p=0.01, respectively). The IR index HOMA-IR also significantly positively correlated with EO in the group with a EAT ≥7 mm (r=0.68, p=0.01). BMI and WC did not correlate with FLI, IR in both groups 1 and 2 (p>0.05). In the EO group, 11 patients had IR with a HOMA-IR index >2.7. Using the linear regression analysis, the regression equation was obtained and the value of EO was calculated, from which the IR with HOMA-IR >2.7 started to be determined. This figure was 9.5 mm. Conclusions EO (EAT ≥7 mm) is a significant predictor of LR and IR, unlike the generally accepted criteria for obesity (BMI, WC). A EAT ≥9.5 mm can be a significant predictor of the development of type 2 diabetes, so these patients need additional examinations.