Abstract P154: Pericardial Adiposity Predicts Incident Diabetes: The Multi-Ethnic Study of Atherosclerosis
Pericardial adipose tissue (PAT) is ectopic fat deep (epicardial adipose tissue) and superficial (paracardial adipose tissue) to the pericardium of the heart. PAT has been cross-sectionally associated with diabetes, but the association with development of diabetes is unclear. Using data from the Multi-Ethnic Study of Atherosclerosis (MESA), we tested whether PAT at baseline was associated with incident diabetes over nearly 10 years of follow-up. The baseline visit (visit 1) was conducted between 2000-2002. Four follow-up visits were conducted at 2 year intervals with visit 5 between 2010 and 2012. Diabetes was defined as a fasting glucose ≥126 mg/dl or the use of antidiabetic medication. Diabetes-free participants at baseline were followed for incident diabetes at any subsequent visit (visits 2-5). Volume of PAT was measured from computed tomographic (CT) scans taken at visits 1 - 4. CT scans were completed on all participants at baseline. Repeat scans were performed on random halves at visits 2 and 3, and a subset at visit 4. Multivariable Cox proportional hazards models were used to assess the association between PAT and incident diabetes.
The figure presents the mean PAT by visit and the mean PAT at baseline among those without diabetes at any time during the study period and those that develop diabetes over the 10 years of follow-up. In Cox regression models adjusted for age, race, and sex, each SD increment of baseline PAT (42.0 mL) was associated with a hazard ratio (HR) for incident diabetes of 1.6 (95% CI 1.5-1.7, p<0.0001). After adjusting for baseline BMI and waist-to-hip ratio, the HR was attenuated somewhat, but remained significant: HR 1.3 (95% CI 1.2-1.4, p<0.0001). Addition of waist circumference to the model did not alter PAT results further.
We found that PAT was highly stable over time, accumulating very slowly. Its baseline value strongly predicts incident diabetes independent of overall body mass and central fatness.
Author Disclosures: A.C. Alman: None. D.R. Jacobs: None. M.A. Allison: None. J.J. Carr: None. F. Hsu: None. J.G. Terry: None. J.K. Snell-Bergeon: None. C.E. Lewis: None. A.G. Bertoni: None. D.C. Goff: None. J. Ding: None.
- © 2015 by American Heart Association, Inc.