Centre for Inflammation and Metabolism/Centre for Physical Activity Research, Rigshospitalet, Copenhagen, Denmark.
The Diabetes Complications Research Group, Steno Diabetes Center Copenhagen, Gentofte, Denmark.
Diabetes Obes Metab. 2019 Aug;21(8):2006-2011. doi: 10.1111/dom.13758. Epub 2019 May 22.
The aim of this study was to investigate the association of epicardial (EAT) and pericardial (PAT) adipose tissues with myocardial function in type 2 diabetes (T2D). EAT and PAT were measured by ultrasound in 770 patients with T2D and 234 age- and sex-matched non-diabetic controls. Echocardiography was performed, including tissue Doppler imaging and 2D speckle tracking. Patients with T2D versus controls had increased EAT (4.6 ± 1.8 mm vs. 3.4 ± 1.2 mm, P < 0.0001) and PAT (6.3 ± 2.8 mm vs. 5.3 ± 2.4 mm, P < 0.0001). EAT and PAT were associated with structural cardiac measures both in T2D patients and controls (all P < 0.043), but only in T2D patients with functional measures: PAT was associated with impaired global longitudinal strain [beta coefficient (SE)] [0.11% (0.04), P = 0.002], while EAT was associated with reduced diastolic function by lateral early diastolic myocardial velocity (e' ) [-0.31 (0.05) cm/s, P = 0.001], mitral inflow velocities: peak early (E)/peak atrial (A) ratio [-0.02 (0.01), P = 0.001] and lateral E/e' [0.36 (0.10), P < 0.001]. However, no interaction was found between diabetes status and PAT (P = 0.75) or EAT (P = 0.45). Adipose tissue in intimate relation to the myocardium is higher in patients with T2D versus controls and is associated with functional myocardial measures in T2D.
本研究旨在探讨 2 型糖尿病（T2D）患者的心外膜（EAT）和心包脂肪组织（PAT）与心肌功能的关系。在 770 例 T2D 患者和 234 例年龄和性别匹配的非糖尿病对照者中，通过超声测量 EAT 和 PAT。进行了超声心动图检查，包括组织多普勒成像和二维斑点追踪。与对照组相比，T2D 患者的 EAT（4.6±1.8mm 比 3.4±1.2mm，P<0.0001）和 PAT（6.3±2.8mm 比 5.3±2.4mm，P<0.0001）均增加。EAT 和 PAT 与 T2D 患者和对照组的结构性心脏测量均相关（均 P<0.043），但仅与 T2D 患者的功能性测量相关：PAT 与整体纵向应变受损相关[β系数（SE）] [0.11%（0.04），P=0.002]，而 EAT 与横向舒张早期心肌速度（e'）降低有关[0.31（0.05）cm/s，P=0.001]，二尖瓣血流速度：E/A 峰值比[0.02（0.01），P=0.001]和横向 E/e'[0.36（0.10），P<0.001]。然而，未发现糖尿病状态与 PAT（P=0.75）或 EAT（P=0.45）之间存在交互作用。与对照组相比，T2D 患者心外膜脂肪组织与心肌密切相关，且与 T2D 患者的心肌功能测量相关。
