Graduate Institute of Health Care Organization Administration, College of Public Health National Taiwan University, Taipei, Taiwan.
BMC Cardiovasc Disord. 2013 Nov 11;13:98. doi: 10.1186/1471-2261-13-98.
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.
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.
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.
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.
与胰岛素抵抗相关的中心性肥胖与 2 型糖尿病的发生密切相关。然而，关于心包和胸主动脉周围脂肪堆积（内脏脂肪组织负担的潜在估计）与糖尿病前期状态之间的关系的数据尚不清楚。本研究旨在探讨通过多探测器 CT（MDCT）定量检测的心包和胸主动脉周围脂肪组织程度在正常、糖尿病前期和显性糖尿病人群中是否存在显著差异。
我们研究了 562 名连续患者，包括 357 名健康者、155 名糖尿病前期患者和 50 名糖尿病患者，这些患者均选自在台湾进行年度健康检查的参与者。糖尿病前期状态根据美国糖尿病协会指南定义为空腹血糖受损或葡萄糖耐量受损。使用非对比 16 层多探测器 CT（MDCT）数据集（Aquarius 3D 工作站，TeraRecon，San Mateo，CA，USA）进行离线测量，评估心包（PCF）和胸主动脉周围（TAT）脂肪组织负担。还评估了体脂肪成分、血清高敏 C 反应蛋白（hs-CRP）水平和胰岛素抵抗（HOMA-IR）。
与正常组相比，糖尿病和糖尿病前期患者的 PCF 体积更大（89 ± 24.6、85.3 ± 28.7 和 67.6 ± 26.7 ml，p < 0.001），TAT 也更大（9.6 ± 3.1 ml 比 8.8 ± 4.2 和 6.6 ± 3.5 ml，p < 0.001），尽管糖尿病和糖尿病前期患者之间的脂肪堆积没有显著差异。在我们的研究中，对于那些没有确诊糖尿病的患者，TAT 负担的增加（而非 PCF）与多变量模型中的胰岛素抵抗（HOMA-IR）和 hs-CRP 相关。
与血糖正常者相比，糖尿病前期和糖尿病患者的心包和胸主动脉周围脂肪组织负担明显更高。此外，胸主动脉周围的内脏脂肪堆积似乎对胰岛素抵抗和全身炎症有显著影响。
