Relationships between the morphometric characteristics of epicardial adipose tissue and anthropometric parameters and metabolic status in patients with coronary artery disease and coronary atherosclerosis with and without type 2 diabetes
TL;DR
In patients with CAD and coronary atherosclerosis, the presence of T2D, PCSK9 levels, and EAT volume combined determine the probability of EAT adipocyte hypertrophy.
Abstract
Aim . To study the relationship between the morphometric characteristics of epicardial adipose tissue (EAT) adipocytes and the degree of their accumulation, anthropometric parameters of obesity, and metabolic impairment in patients with coronary artery disease (CAD) undergoing coronary artery bypass grafting (CABG), depending on type 2 diabetes (T2D). Material and methods . Forty-six patients (male, 38; female, 8) aged 44-75 years with CAD and indications for CABG were included. EAT adipocytes were obtained intraoperatively, and their size and degree of hypertrophy were determined. EAT volume was assessed using non-contrast cardiac computed tomography (CT). Blood lipid transport function, carbohydrate metabolism, proprotein convertase subtilisin/ kexin type 9 (PCSK9) levels, and adipokines were assessed. Results . In the general group, the mean adipocyte size correlated with the adiponectin/leptin ratio (r s =-0,49, p=0,001), levels of C-peptide (r s =0,47, p=0,002), PCSK9 (r s =0,45, p=0,004), triglycerides (r s =0,39, p=0,014) and EAT indexed to body surface area (r s =0,36, p=0,022). In the presence of T2D (n=14), the mean adipocyte size correlated with body weight (r s =-0,72, p=0,013), waist circumference (r s =-0,64, p=0,033), hip circumference (r s =-0,62, p=0,042) and triglyceride levels (r s =0,60, p=0,043). In patients without T2D (n=32), these correlations were absent, while adipocyte size demonstrated correlations with EAT volume (r s =0,41, p=0,025), blood PCSK9 levels (r s =0,41, p=0,025), leptin (r s =0,42, p=0,023), and the adiponectin/leptin ratio (r s =-0,46, p=0,012). According to the logistic regression model, the probability of large and hypertrophic EAT adipocytes is determined by the blood PCSK9 level, EAT volume, and the presence of T2D. The predictive accuracy of the model was 90%, sensitivity — 85,71%, and specificity — 94,74%. Conclusion . In patients with CAD and coronary atherosclerosis, the presence of T2D, PCSK9 levels, and EAT volume combined determine the probability of EAT adipocyte hypertrophy. A direct relationship between the EAT adipocyte size, the degree of its hypertrophy, and EAT volume was established only in patients without T2D.