Differential association of visceral adipose tissue with coronary plaque characteristics in patients with and without diabetes mellitus

Kazuhiro Osawa, Toru Miyoshi, Yasushi Koyama, Shuhei Sato, Noriaki Akagi, Yusuke Morimitsu, Motoki Kubo, Hiroki Sugiyama, Kazufumi Nakamura, Hiroshi Morita, Susumu Kanazawa, Hiroshi Itoh

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Background: Excess visceral adipose tissue (VAT) is closely associated with the presence of coronary artery plaques that are vulnerable to rupture. Patients with diabetes mellitus (DM) have more VAT than patients without DM, but the extent to which VAT contributes to the characteristics of coronary plaques before and after the development of DM is not fully understood.Methods: We retrospectively evaluated 456 patients (60% male, age 64 ± 16 years) who were suspected to have cardiovascular disease and underwent 64-slice computed tomography angiography (CTA). Seventy-one (16%) patients had vulnerable plaques (CT density <50 Hounsfield Units, positive remodeling index > 1.05, and adjacent spotty areas of calcification).Results: Patients were divided into tertiles according to the VAT area. There were stepwise increases in noncalcified and vulnerable plaques with increasing tertiles of VAT area in patients without DM, but not in patients with DM. Multivariate analysis showed that a larger VAT area was significantly associated with a higher risk of vulnerable plaque in patients without DM (odds ratio 3.17, 95% confidence interval 1.08-9.31, p = 0.04), but not in patients with DM.Conclusions: The VAT area is associated with the characteristics of coronary plaques on CTA in patients without DM, but not in patients with DM. VAT may be a significant cardiometabolic risk factor that is associated with plaque vulnerability before the development of DM. CTA findings may help to improve risk stratification in such patients.

Original languageEnglish
Article number61
JournalCardiovascular Diabetology
Volume13
Issue number1
DOIs
Publication statusPublished - Mar 14 2014

Fingerprint

Intra-Abdominal Fat
Diabetes Mellitus
Rupture
Coronary Vessels
Cardiovascular Diseases
Multivariate Analysis
Odds Ratio
Confidence Intervals

Keywords

  • Coronary artery disease
  • Diabetes mellitus
  • Visceral adipose tissue

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Endocrinology, Diabetes and Metabolism

Cite this

Differential association of visceral adipose tissue with coronary plaque characteristics in patients with and without diabetes mellitus. / Osawa, Kazuhiro; Miyoshi, Toru; Koyama, Yasushi; Sato, Shuhei; Akagi, Noriaki; Morimitsu, Yusuke; Kubo, Motoki; Sugiyama, Hiroki; Nakamura, Kazufumi; Morita, Hiroshi; Kanazawa, Susumu; Itoh, Hiroshi.

In: Cardiovascular Diabetology, Vol. 13, No. 1, 61, 14.03.2014.

Research output: Contribution to journalArticle

@article{cd23f137dff24784bc77a363e43af7b8,
title = "Differential association of visceral adipose tissue with coronary plaque characteristics in patients with and without diabetes mellitus",
abstract = "Background: Excess visceral adipose tissue (VAT) is closely associated with the presence of coronary artery plaques that are vulnerable to rupture. Patients with diabetes mellitus (DM) have more VAT than patients without DM, but the extent to which VAT contributes to the characteristics of coronary plaques before and after the development of DM is not fully understood.Methods: We retrospectively evaluated 456 patients (60{\%} male, age 64 ± 16 years) who were suspected to have cardiovascular disease and underwent 64-slice computed tomography angiography (CTA). Seventy-one (16{\%}) patients had vulnerable plaques (CT density <50 Hounsfield Units, positive remodeling index > 1.05, and adjacent spotty areas of calcification).Results: Patients were divided into tertiles according to the VAT area. There were stepwise increases in noncalcified and vulnerable plaques with increasing tertiles of VAT area in patients without DM, but not in patients with DM. Multivariate analysis showed that a larger VAT area was significantly associated with a higher risk of vulnerable plaque in patients without DM (odds ratio 3.17, 95{\%} confidence interval 1.08-9.31, p = 0.04), but not in patients with DM.Conclusions: The VAT area is associated with the characteristics of coronary plaques on CTA in patients without DM, but not in patients with DM. VAT may be a significant cardiometabolic risk factor that is associated with plaque vulnerability before the development of DM. CTA findings may help to improve risk stratification in such patients.",
keywords = "Coronary artery disease, Diabetes mellitus, Visceral adipose tissue",
author = "Kazuhiro Osawa and Toru Miyoshi and Yasushi Koyama and Shuhei Sato and Noriaki Akagi and Yusuke Morimitsu and Motoki Kubo and Hiroki Sugiyama and Kazufumi Nakamura and Hiroshi Morita and Susumu Kanazawa and Hiroshi Itoh",
year = "2014",
month = "3",
day = "14",
doi = "10.1186/1475-2840-13-61",
language = "English",
volume = "13",
journal = "Cardiovascular Diabetology",
issn = "1475-2840",
publisher = "BioMed Central",
number = "1",

}

TY - JOUR

T1 - Differential association of visceral adipose tissue with coronary plaque characteristics in patients with and without diabetes mellitus

AU - Osawa, Kazuhiro

AU - Miyoshi, Toru

AU - Koyama, Yasushi

AU - Sato, Shuhei

AU - Akagi, Noriaki

AU - Morimitsu, Yusuke

AU - Kubo, Motoki

AU - Sugiyama, Hiroki

AU - Nakamura, Kazufumi

AU - Morita, Hiroshi

AU - Kanazawa, Susumu

AU - Itoh, Hiroshi

PY - 2014/3/14

Y1 - 2014/3/14

N2 - Background: Excess visceral adipose tissue (VAT) is closely associated with the presence of coronary artery plaques that are vulnerable to rupture. Patients with diabetes mellitus (DM) have more VAT than patients without DM, but the extent to which VAT contributes to the characteristics of coronary plaques before and after the development of DM is not fully understood.Methods: We retrospectively evaluated 456 patients (60% male, age 64 ± 16 years) who were suspected to have cardiovascular disease and underwent 64-slice computed tomography angiography (CTA). Seventy-one (16%) patients had vulnerable plaques (CT density <50 Hounsfield Units, positive remodeling index > 1.05, and adjacent spotty areas of calcification).Results: Patients were divided into tertiles according to the VAT area. There were stepwise increases in noncalcified and vulnerable plaques with increasing tertiles of VAT area in patients without DM, but not in patients with DM. Multivariate analysis showed that a larger VAT area was significantly associated with a higher risk of vulnerable plaque in patients without DM (odds ratio 3.17, 95% confidence interval 1.08-9.31, p = 0.04), but not in patients with DM.Conclusions: The VAT area is associated with the characteristics of coronary plaques on CTA in patients without DM, but not in patients with DM. VAT may be a significant cardiometabolic risk factor that is associated with plaque vulnerability before the development of DM. CTA findings may help to improve risk stratification in such patients.

AB - Background: Excess visceral adipose tissue (VAT) is closely associated with the presence of coronary artery plaques that are vulnerable to rupture. Patients with diabetes mellitus (DM) have more VAT than patients without DM, but the extent to which VAT contributes to the characteristics of coronary plaques before and after the development of DM is not fully understood.Methods: We retrospectively evaluated 456 patients (60% male, age 64 ± 16 years) who were suspected to have cardiovascular disease and underwent 64-slice computed tomography angiography (CTA). Seventy-one (16%) patients had vulnerable plaques (CT density <50 Hounsfield Units, positive remodeling index > 1.05, and adjacent spotty areas of calcification).Results: Patients were divided into tertiles according to the VAT area. There were stepwise increases in noncalcified and vulnerable plaques with increasing tertiles of VAT area in patients without DM, but not in patients with DM. Multivariate analysis showed that a larger VAT area was significantly associated with a higher risk of vulnerable plaque in patients without DM (odds ratio 3.17, 95% confidence interval 1.08-9.31, p = 0.04), but not in patients with DM.Conclusions: The VAT area is associated with the characteristics of coronary plaques on CTA in patients without DM, but not in patients with DM. VAT may be a significant cardiometabolic risk factor that is associated with plaque vulnerability before the development of DM. CTA findings may help to improve risk stratification in such patients.

KW - Coronary artery disease

KW - Diabetes mellitus

KW - Visceral adipose tissue

UR - http://www.scopus.com/inward/record.url?scp=84897476344&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84897476344&partnerID=8YFLogxK

U2 - 10.1186/1475-2840-13-61

DO - 10.1186/1475-2840-13-61

M3 - Article

C2 - 24624968

AN - SCOPUS:84897476344

VL - 13

JO - Cardiovascular Diabetology

JF - Cardiovascular Diabetology

SN - 1475-2840

IS - 1

M1 - 61

ER -