心包内脂肪容积对糖尿病及非糖尿病患者冠状动脉粥样硬化影响的CT评价

Effect of Epicardial Adipose Tissue Volume by CCTA on Coronary Atherosclerosis in Patients with or without Type 2 Diabetes Mellitus

目的本研究旨在探讨CT量化的心包内脂肪(EAT)容积在2型糖尿病(T2DM)及非糖尿病(non-DM)患者中对冠状动脉粥样硬化影响的差异,以及EAT与心血管危险因素的关系。方法收集2018年1—12月于四川大学华西医院行CT冠状动脉造影(CCTA)检查的住院患者,将患者分为T2DM组和non-DM组,测量ETA容积,评估患者冠状动脉粥样硬化的发生及严重程度,收集患者临床基本资料及生化检查资料。结果T2DM组EAT容积明显高于non-DM组(P=0.001),冠状动脉粥样硬化的发生、累及节段及Gensini评分均显著高于non-DM组(所有P<0.05)。在non-DM组,EAT容积在冠状动脉斑块有无(P=0.019)、易损斑块出现(P=0.048)和冠状动脉狭窄程度(P=0.046)的各组间有明显差异,且与累及冠状动脉节段(P=0.047)及Gensini评分(P=0.023)具有一定的相关性,T2DM组患者中未发现明显差异性及相关性。结论T2DM组患者冠状动脉粥样硬化的发生及病变程度和EAT容积都明显高于non-DM组,但EAT与冠状动脉粥样硬化的发生及严重程度,却未像nonDM组一样表现出良好的相关性。

Objective To evaluate the effect of computed tomography-quantified epicardial adipose tissue(EAT)on coronary atherosclerosis,and the relationship between EAT and cardiovascular risk factors in patients with or without type 2 diabetes mellitus(T2 DM).Methods The inpatients scanned with coronary computed tomography angiography(CCTA)from January to December 2018 in West China Hospital were enrolled and classified into T2 DM and non-diabetic(non-DM)group.The EAT volume was measured and extent and complexity of coronary atherosclerosis evaluated by CCTA.The basic clinical and other biochemical data were collected.Results The mean EAT volume in T2 DM group was significantly higher than that in non-DM group(P=0.001).The morbidity,involved segments and Gensini score of coronary atherosclerosis were all statistically increased in diabetic patients compared with non-DM patients(each P<0.05).Furthermore,there exit an apparent difference on EAT volume when involving the presence and absence of plaques(P=0.019),vulnerable plaques(P=0.048)and degree of coronary stenosis(P=0.046)in non-DM group,and a moderate correlation of EAT volume with involved coronary segments(P=0.047)and Gensini score(P=0.023),which were not found in diabetic patients.Conclusion The mobidity and severity of coronary atherosclerosis as well as EAT volume are all increased in T2 DM patients.However,the correlation of EAT volume with mobidity and severity of coronary atherosclerosis in T2 DM patients seems not so parallel with non-diabetic patients.