Aslan Abdullah Nabi, Keleş Telat, Ayhan Hüseyin, Kasapkara Hacı Ahmet, Akçay Murat, Durmaz Tahir, Sarı Cenk, Baştuğ Serdal, Çakır Bekir, Bozkurt Engin
Department of Cardiology, Ankara Ataturk Education and Research Hospital, Ankara, Turkey.
Department of Cardiology, Faculty of Medicine, Yıldırım Beyazıt University, Ankara, Turkey.
Echocardiography. 2015 Dec;32(12):1745-53. doi: 10.1111/echo.12960. Epub 2015 Apr 27.
Epicardial adipose tissue (EAT) is a new independent marker of coronary artery disease (CAD). The aim of this study was to investigate the relationship between epicardial fat thickness (EFT) and endothelial dysfunction (ED) in patients with type I diabetes mellitus (TIDM).
Seventy-six type I diabetic patients (diabetes duration 11.7 ± 8,1 years, aged 30.6 ± 10 years; female/male: 38/38) and 36 healthy controls were enrolled into the study. Fasting plasma glucose (FPG), lipid panel, glycosylated hemoglobin (HbA1C), high-sensitive C-reactive protein (hsCRP), and fibrinogen levels were determined. EFT was measured via two-dimensional (2D) M-mode echocardiography. Endothelial function was assessed as flow-mediated dilatation (FMD) at the brachial artery using high-resolution ultrasound. EFT was significantly higher in patients compared to controls (3.56 ± 0.48 mm vs. 3.03 ± 0.48 mm, P < 0.001). In addition, significant differences were observed between the patient and control groups in terms of FMD (6.70% ± 1.63 vs. 9.99% ± 1.84, respectively, P < 0.001). EFT was shown to be correlated negatively with FMD (r: -0.94, P < 0.001) and positively with hsCRP (r: 0.41, P < 0.001) and fibrinogen (r: 0. 31, P = 0.007). Multiple regression analysis showed EFT to be an independent factor influencing the endothelial function.
There was inverse relationship between EFT and endothelial function in this study. EFT measured easily by transthoracic echocardiography may be a useful parameter in the assessment of patients with TIDM.
心外膜脂肪组织（EAT）是冠状动脉疾病（CAD）一个新的独立标志物。本研究旨在探讨1型糖尿病（TIDM）患者的心外膜脂肪厚度（EFT）与内皮功能障碍（ED）之间的关系。
本研究纳入了76例1型糖尿病患者（糖尿病病程11.7±8.1年，年龄30.6±10岁；女性/男性：38/38）和36例健康对照者。测定空腹血糖（FPG）、血脂、糖化血红蛋白（HbA1C）、高敏C反应蛋白（hsCRP）和纤维蛋白原水平。通过二维（2D）M型超声心动图测量EFT。使用高分辨率超声评估肱动脉的血流介导的扩张（FMD）来评价内皮功能。与对照组相比，患者的EFT显著更高（3.56±0.48mm对3.03±0.48mm，P<0.0０1）。此外，患者组和对照组在FMD方面也观察到显著差异（分别为6.70%±1.63对9.99%±1.84，P<0.001）。EFT与FMD呈负相关（r：-0.９4，P<0.001），与hsCRP呈正相关（r：0.41，P<0.001），与纤维蛋白原呈正相关（r：0.31，P=0.007）。多元回归分析显示EFT是影响内皮功能的一个独立因素。
本研究中EFT与内皮功能之间存在负相关关系。经胸超声心动图易于测量的EFT可能是评估TIDM患者的一个有用参数。
