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Coronary artery calcifications and diastolic dysfunction versus visceral fat area in type 1 diabetes: VISCERA study
Christophe E M De Block1, Bharati Shivalkar2, Wouter Goovaerts3
1University of Antwerp, Faculty of Medicine & Health Sciences, Laboratory of Experimental Medicine and Pediatrics (LEMP), Antwerp, Belgium; Department of Endocrinology, Diabetology & Metabolism, Antwerp University Hospital, Edegem, Belgium.
Insights
Visceral adipose tissue (VAT) is linked to coronary artery calcifications (CAC) and diastolic dysfunction in type 1 diabetic patients (T1DM). Early detection of VAT may help reduce cardiovascular risk in this population.
Area of Science:
- Cardiology
- Endocrinology
- Metabolic Syndrome
Background:
- Type 1 diabetic patients (T1DM) have increased cardiovascular disease and mortality risks.
- Visceral adipose tissue (VAT) accumulation is a potential contributor to cardiovascular complications in T1DM.
Purpose of the Study:
- To investigate the association between visceral adipose tissue (VAT) and coronary artery calcifications (CAC) in T1DM patients.
- To determine if VAT contributes to cardiac dysfunction, specifically diastolic dysfunction, in T1DM.
Main Methods:
- A cross-sectional study involving 118 T1DM patients without prior cardiovascular disease.
- Coronary artery calcifications (CAC) and visceral adipose tissue (VAT) were quantified using CT scans.
- Cardiac function was assessed via echocardiography to identify diastolic dysfunction.
Main Results:
- 42% of T1DM patients had CAC (score ≥10), and 75% exhibited diastolic dysfunction.
- 46% of patients had significant VAT (≥100cm²), which was associated with higher CAC prevalence (54% vs 31%, p=0.01).
- Independent predictors for CAC included age, diabetes duration, gender, LDL-cholesterol, and metabolic syndrome. Age, waist circumference, and VAT were linked to diastolic dysfunction.
Conclusions:
- Excess visceral adipose tissue (VAT) is prevalent in T1DM patients and is associated with both coronary artery calcifications (CAC) and diastolic dysfunction.
- These findings suggest that VAT plays a significant role in the elevated cardiovascular risk observed in T1DM.
- Timely assessment and management of VAT may be crucial for mitigating future cardiovascular events in individuals with type 1 diabetes.
Aims:
Type 1 diabetic patients (T1DM) experience a higher cardiovascular disease and mortality risk than controls. We investigated whether visceral adipose tissue (VAT) contributes to coronary artery calcifications (CAC) and cardiac dysfunction in T1DM.
Methods:
A cross-sectional study of 118 T1DM patients without a history of cardiovascular disease (men/women: 68/50, age 46±12years, HbA1c 7.6±0.9%, BMI 25.8±4.1kg/m2) was conducted. CAC and VAT were measured using a CT scan. CAC was scored using the Agatston method. Cardiac functional abnormalities were assessed by echocardiography.
Results:
CAC scored ≥10 in 42% of patients. Systolic function was normal in all, but diastolic dysfunction was present in 75%. Forty-six percent had VAT≥100cm2. CAC score≥10 occurred more often in subjects with VAT≥100cm2 (54% vs 31%; p=0.01). Age (OR=1.10; p<0.0001), diabetes duration (OR=1.10; p=0.008), gender (OR=4.28; p=0.016), LDL-cholesterol (OR=1.03; p=0.009) and metabolic syndrome (OR=5.79; p=0.005) were independently associated with a CACS≥10. Subjects with CACS≥10 were more prone to have diastolic dysfunction (84 vs 54%; p=0.03). Factors independently associated with diastolic dysfunction were age (OR=1.11; p=0.002), waist circumference (OR=1.10; p=0.016) and VAT (OR=0.99; p=0.035).
Conclusions:
Excess VAT in T1DM, present in 46%, is associated with diastolic dysfunction and CAC, present in respectively 75% and 42% of patients. Timely detection might improve future cardiovascular risk.
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