EPICARDIAL ADIPOSE TISSUE IN PATIENTS WITH LONG-TERM TYPE 1 DIABETES IN RELATION TO METABOLIC AND INFLAMMATION MARKERS

Objective: Type 1 diabetes mellitus (T1DM) shows constantly increasing survival rate which poses the need to investigate cardiovascular diseases risk factors. The accumulation of epicardial adipose tissue (EAT) is considered recently to be one of the most important metabolic risk factors for the development of cardiovascular events. Aim: to assess the presence of EAT in patients with T1DM without cardiovascular diseases or chronic complications in relation to metabolic and inflammation cardiovascular risk markers in patients with T1DM.Design and method: We evaluated 124 patients with long-term T1DM at a mean age 42.68±10.4 years, 53% males, with a median duration of T1DM 24 years. The mean HbA1c% level at the time of inclusion in the study was 8.42±1.75%. Visceral adiposity tissue (VAT) was assessed by means of dual-energy X-ray absorptiometry (DEXA). Fasting blood samples were drawn for analysis of various biomarkers of adiposity and inflammation, such as adiponectin, leptin, irisin, Interleukin-6 (Il-6), TNF-alpha, siCAM, tested by an enzyme-linked immunosorbent assay (ELISA). Magnetic resonance imaging (MRI) was performed and epicardial adipose tissue (EAT) volume was calculated. Non-parametric correlation coefficients between the biomarkers and EAT were defined. Results: The EAT volume increased with increasing visceral adipose tissue by DEXA, p<0.0001 (Table 1). There was significant negative moderate correlation between EAT volume and adiponectin – Spearman’s rho=-0.36, p<0.0001 and with Il-6 – rho=-0.34, p=0.001. There were no other significant correlations with other markers of metabolic and inflammatory changes although some showed interesting trends. Limitation of the current study is the relatively small number of T1DM patients. Its strength is the homogeneity of the study group, the long duration of T1DM and the prevailing not good diabetes control. Conclusions: EAT is parallel to abdominal VAT increase in patients with T1DM. The fat tissue around the heart correlates well with established metabolic and inflammation biomarkers but not with others. However, the results merit the conclusion that measures to limit the accumulation of VAT in type 1 diabetes patients should be included in treatment plans from the initial diagnosis.