Arpaci Dilek, Ugurlu Burcak Polat, Aslan Abdullah Nabi, Ersoy Reyhan, Akcay Murat, Cakir Bekir
Department of Endocrinology and Metabolism, Sakarya University Education and Research Hospital, Turkey.
Intern Med. 2015;54(9):1009-14. doi: 10.2169/internalmedicine.54.3714. Epub 2015 May 1.
Prediabetes is a condition between a normal metabolic state and diabetes mellitus, which includes impaired glucose tolerance (IGT), impaired fasting glucose (IFG), or both. Prediabetes is related with undesirable cardiovascular outcomes. Epicardial fat thickness (EFT) has been correlated with cardiovascular risk factors. We herein aimed to assess EFT in prediabetic patients.
We evaluated 64 patients with prediabetes and 30 age- and gender-matched healthy subjects. Demographic and anthropometric characteristics [age, sex, height, weight, body mass index (BMI), and waist circumference (WC)] and laboratory findings [fasting plasma glucose (FPG), postprandial plasma glucose (PPG), hemoglobin A1c (HbA1c), low density lipoprotein (LDL), high density lipoprotein (HDL), and triglycerides (TG)] were assessed. Transthoracic echocardiography was used to evaluate EFT.
There were no significant differences between the case and control groups in terms of age, gender, height, HDL, WC, systolic and diastolic blood pressure (SBP/DBP), or TG (p>0.05). Body weight, BMI, FPG, LDL, and, in particular, EFT were found to be significantly higher in the case group than control group (p<0.05). When compared with the control group, the median EFT was significantly higher in all prediabetic subgroups (IGT or IFG, p<0.001). However, no statistically significant difference was found between each case subgroup (p=0.795). When groups were adjusted according to age, sex, WC, and BMI with covariance test, the EFT remained increased in the prediabetes subgroups compared to the controls (p<0.001).
We found the EFT levels to be increased in all subgroups of prediabetic patients regardless of FPG and HbA1c. Furthermore, EFT directly correlated with the patients' BMI and WC.
糖尿病前期是一种介于正常代谢状态和糖尿病之间的情况，包括糖耐量受损（IGT）、空腹血糖受损（IFG）或两者皆有。糖尿病前期与不良心血管结局相关。心外膜脂肪厚度（EFT）与心血管危险因素相关。我们在此旨在评估糖尿病前期患者的心外膜脂肪厚度。
我们评估了64例糖尿病前期患者和30例年龄及性别匹配的健康受试者。评估了人口统计学和人体测量学特征[年龄、性别、身高、体重、体重指数（BMI）和腰围（WC）]以及实验室检查结果[空腹血糖（FPG）、餐后血糖（PPG）、糖化血红蛋白（HbA1c）、低密度脂蛋白（LDL）、高密度脂蛋白（HDL）和甘油三酯（TG）]。采用经胸超声心动图评估心外膜脂肪厚度。
病例组和对照组在年龄、性别、身高、HDL、WC、收缩压和舒张压（SBP/DBP）或TG方面无显著差异（p>0.05）。发现病例组的体重、BMI、FPG、LDL，尤其是EFT显著高于对照组（p<0.05）。与对照组相比，所有糖尿病前期亚组（IGT或IFG）的心外膜脂肪厚度中位数均显著更高（p<0.001）。然而，各病例亚组之间未发现统计学显著差异（p=0.795）。当用协方差检验根据年龄、性别、WC和BMI对各组进行调整时，糖尿病前期亚组的心外膜脂肪厚度与对照组相比仍增加（p<0.001）。
我们发现，无论FPG和HbA1c如何，糖尿病前期患者的所有亚组的心外膜脂肪厚度水平均升高。此外，心外膜脂肪厚度与患者的BMI和WC直接相关。
