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Cardiovascular disease is the most important cause of mortality in patients with type 2 diabetes and is preceded by endothelial dysfunction.Epicardial adipose tissue has shown to be related to cardiovascular risk. An increased epicardial adipose tissue is associated with incident coronary artery disease and major adverse cardiac events. The aim of the present study is to investigate the relationship between epicardial adipose tissue and endothelial function in patients with type 2 Diabetes Mellitus (DM).
Type 2 DM patients were divided into two groups according to their brachial flow mediated dilatation values. The endothelial dysfunction group consisted of 46 participants with flow mediated dilatation change <7%, while 46 participants with flow-mediated dilatation change >7% were accepted as the non-endothelial dysfunction group. Thickness of the epicardial adipose tissue (EAT) was measured to right ventricular free wall adjacent to the parasternal long and short axis images. The patients' demographic, anthropometric and laboratory findings were recorded.
The mean FMD values of patients were 13.2±4.9% in Non-ED Group and 3.5±3.4% in ED Group (p<0.001). Table 1 shows the baseline characteristics of patients. The EAT short and long axis diameters were shown in Figure 1. The HbA1c levels were significantly higher in ED Group than Non-ED Group (respectively, 8.7±1.9%, 7.9±1.6%, p<0.038). There were a negative correlation between FMD values and EAT short and long axis diameters (respectively; r=-0,349, p=0.001, r=-0,351, p=0.001). The hematologic parameters including; white blood count, hemoglobine, platelet, lymphocyte count, red cell distribution width, mean platelet volume, neutrophil lymphocyte ratio and platelet lymphocyte ratio were similar between two groups. The neutrophil counts were higher in ED group than Non-ED Group (4723±1651 vs 4091±1252, p=0,041). In logistic regression analyses, HbA1c and EAT short axis diameter were found as predictors for ED (CI 95% was 2,278 for HbA1c, p=0.006 and CI 95% was 2,953 for EAT short axis diameter, p=0.0022).
Increased EAT diameters and HbA1c predict ED in patients with type 2 DM.
|ED Group (n=46)||Non-ED|
|Duration of diabetes mellitus (month)||50.3||42.6||0.1|
|History of (%)|
|Fasting glucose (mg/dL)||202±80||189±70||0.3|
|Total- Cholesterole (mg/dL)||205±51||199±45||0.5|
|Low Density Lipoprotein Cholesterole (mg/dL)||124±37||117±39||0.3|
|High Density Lipoprotein Cholesterole (mg/dL)||41±9||43±10||0.5|
|CRP (mg/dL)||5.5± 5.0||4.5± 5.1||0.3|
|Body Mass Index (kg/m2)||32.4±5.8||31.1±3.7||0.1|
The clinical and biochemical properties of patients with type 2 diabetes mellitus.