Diabetes Unit, Department of Medical-Surgical Sciences and Biotechnologies, Santa Maria Goretti Hospital, Sapienza University of Rome, Latina, Italy.
Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
Endocrine. 2022 Jan;75(1):10-18. doi: 10.1007/s12020-021-02925-5. Epub 2021 Nov 3.
To study the possible association of CT-derived quantitative epicardial adipose tissue (EAT) and glycemia at the admission, with severe outcomes in patients with COVID-19.
Two hundred and twenty-nine patients consecutively hospitalized for COVID-19 from March 1st to June 30th 2020 were studied. Non contrast chest CT scans, to confirm diagnosis of pneumonia, were performed. EAT volume (cm) and attenuation (Hounsfield units) were measured using a CT post-processing software. The primary outcome was acute respiratory distress syndrome (ARDS) or in-hospital death.
The primary outcome occurred in 56.8% patients. Fasting blood glucose was significantly higher in the group ARDS/death than in the group with better prognosis [114 (98-144) vs. 101 (91-118) mg/dl, p = 0.001]. EAT volume was higher in patients with vs without the primary outcome [103 (69.25; 129.75) vs. 78.95 (50.7; 100.25) cm, p < 0.001] and it was positively correlated with glycemia, PCR, fibrinogen, P/F ratio. In the multivariable logistic regression analysis, age and EAT volume were independently associated with ARDS/death. Glycemia and EAT attenuation would appear to be factors involved in ARDS/death with a trend of statistical significance.
Our findings suggest that both blood glucose and EAT, easily measurable and modifiable targets, could be important predisposing factors for severe Covid-19 complications.
研究 COVID-19 患者入院时 CT 定量检测的心外膜脂肪组织（EAT）和血糖与严重结局的可能相关性。
对 2020 年 3 月 1 日至 6 月 30 日期间连续因 COVID-19 住院的 229 例患者进行了研究。进行非对比性胸部 CT 扫描以确认肺炎诊断。使用 CT 后处理软件测量 EAT 体积（cm）和衰减（Hounsfield 单位）。主要结局是急性呼吸窘迫综合征（ARDS）或住院内死亡。
主要结局发生在 56.8%的患者中。ARDS/死亡组的空腹血糖明显高于预后较好组[114（98-144）比 101（91-118）mg/dl，p=0.001]。与无主要结局的患者相比，有主要结局的患者 EAT 体积更高[103（69.25；129.75）比 78.95（50.7；100.25）cm，p<0.001]，且与血糖、PCR、纤维蛋白原、P/F 比值呈正相关。在多变量逻辑回归分析中，年龄和 EAT 体积与 ARDS/死亡独立相关。血糖和 EAT 衰减似乎是 ARDS/死亡的相关因素，具有统计学意义的趋势。
我们的研究结果表明，血糖和 EAT 这两个易于测量和可改变的目标，可能是 COVID-19 严重并发症的重要易患因素。
