Preview

Russian Journal of Cardiology

Advanced search

A NON-INVASIVE MARKER OF INSULIN RESISTANCE IN PATIENTS WITH OBESITY

https://doi.org/10.15829/1560-4071-2013-6-28-32

Abstract

Insulin resistance (IR) and hormone activity of visceral fat are the main pathogenetic mechanisms which link obesity and cardiovascular complications. Until recently, the association between epicardial adiposity and IR has been understudied. 

Aim. To investigate the association between the thickness of epicardial fat tissue (tEFT) and IR and to determine the predictive value and threshold levels of tEFT for the diagnostics of IR. 

Material and methods. The study included 186 men (mean age 54,4±9,1 years) with the mean body mass index of 34,23±3,97 kg/m². IR was assessed by the levels of insulin and HOMA-IR index. The echocardiography measurement of tEFT (mm behind the free right ventricular wall) was performed in a systole, in a parasternal position on the long and short left ventricular axis. 

Results. Mean tEFT levels in the IR-positive group were significantly higher (7,0 (7,0;9,0)) than in the IR-negative group (5 (4,0;6,0); p<0,001). In the logistic regression analyses, the proportion of accurate predictions was 91%, and the Somers’ D-value was 0,837. The optimal cut-off for tEFT, as a non-invasive IR marker, was

About the Authors

N. G. Veselovskaya
Research Institute for Complex Cardiovascular Disease Issues, Siberian Branch, Russian Academy of Medical Sciences, Kemerovo; Altay Region Cardiology Dispanser, Barnaul, Russia
Russian Federation


G. A. Chumakova
Research Institute for Complex Cardiovascular Disease Issues, Siberian Branch, Russian Academy of Medical Sciences, Kemerovo; Altay State Medical University, Barnaul
Russian Federation


A. V. Ott
Altay Region Cardiology Dispanser, Barnaul, Russia
Russian Federation

Competing Interests:

врач Алтайского краевого кардиологического диспансера



O. V. Gritsenko
Research Institute for Complex Cardiovascular Disease Issues, Siberian Branch, Russian Academy of Medical Sciences, Kemerovo; Altay State Medical University, Barnaul
Russian Federation


References

1. Romero-Corral A, Montori VM, Somers VK, et al. Association of bodyweight with total mortality and with cardiovascular events in coronary artery disease: A systematic review of cohort studies. Lancet. 2006; 368:666–78.

2. Poirier P, Giles TD, Bray GA, et al. Obesity and cardiovascular disease: pathophysiology, evaluation, and effect of weight loss: an update of the 1997 American Heart Association Scientific Statement on Obesity and Heart Disease from the Obesity Committee of the Council on Nutrition, Physical Activity, and Metabolism. Circulation. 2006; 113 (6):898–918.

3. Reilly MP, Wolfe ML, Rhodes T, et al. Measures of insulin resistance add incremental value to the clinical diagnosis of metabolic syndrome in association with coronary atherosclerosis. Circulation. 2004; 110 (7):803–9.

4. Kim J, Chae YK, Chernoff A. The Risk for Coronary Heart Disease According to Insulin Resistance with and without Type 2 Diabetes. Endocr Res. 2013 [Epub ahead of print].

5. Schnabel R, Messow CM, Lubos E, et al. Association of adiponectin with adverse outcome in coronary artery disease patients: results from the AtheroGene study. JAMA. 2009; 302:345–56.

6. Juge-Aubry CE, Henrichot E, Meier CA. Adipose tissue: a regulator of inflammation. Best Pract Res Clin Endocrinol Metab. 2005; 19 (4):547–66.

7. Montani JP, Carroll JF, Dwyer TM. Ectopic fat storage in heart, blood vessels and kidneys in the pathogenesis of cardiovascular diseases. Int J Obes Relat Metab Disord. 2004; 28:58–65.

8. Iacobellis G, Assael F, Ribaudo MC, et al. Epicardial fat from echocardiography: a new method for visceral adipose tissue prediction. Obes Res. 2003; 11 (2):304–10.

9. Iacobellis G, Sharma AM Adiposity of the heart. Ann Intern Med. 2006; 145:554–5.

10. National Guidelines. Diagnostics and treatment of metabolic syndrome. Ed.2. Cardiovascular Therapy and Prevention 2009; 8 (6):4–6, Supl. 2. Russian (Национальные клинические рекомендации “Диагностика и лечение метаболического синдрома” (второй пересмотр). Кардиоваскулярная терапия и профилактика. 2009; 8 (6):4–6.

11. Приложение 2).

12. Matthews DR, Hosker JP, Rudenski AS, et al. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28:412–419

13. Iacobellis G, Willens HJ, Barbaro G. Threshold Values of High-risk Echocardiographic Epicardial Fat Thickness, Obesity. 2008; 16 (4):887–92.

14. Iacobellis G, Leonetti F. Epicardial adipose tissue and insulin resistance in obese subjects. J Clin Endocrinol Metab. 2005; 90 (11):6300–2.

15. Iacobellis G, Barbaro G, Gerstein HC. Relationship of epicardial fat thickness and fasting glucose. Int J Cardiol. 2008; 128 (3):424–6.

16. Malavazos AE, Ermetici F, Cereda E, et al. Epicardial fat thickness: relationship with plasma visfatin and plasminogen activator inhibitor-1 levels in visceral obesity. Nutr Metab Cardiovasc Dis. 2008; 18 (8):523–30.

17. Ayd n H, Toprak A, Deyneli O. et al. Epicardial Fat Tissue Thickness Correlates With Endothelial Dysfunction and Other Cardiovascular Risk Factors in Patients With Metabolic Syndrome. Metab Syndr Relat Disord. 2010; 8 (3):229–34.

18. Iacobellis G, Ribaudo MC, Assael F, et al. Echocardiographic epicardial adipose tissue is related to anthropometric and clinical parameters of metabolic syndrome: a new indicator of cardiovascular risk. J Clin Endocrinol Metab. 2003; 88 (11):5163–8.

19. Pierdomenico SD, Pierdomenico AM. Epicardial Adipose Tissue and Metabolic Syndrome in Hypertensive Patients With Normal Body Weight and Waist Circumference. Am J Hypertens. 2011; 24:1245–9.

20. Tok D, Kadife I, Turak O. Increased epicardial fat thickness is associated with low grade systemic inflammation in metabolic syndrome. Turk Kardiyol Dern Ars. 2012; 40 (8):690–5.

21. Pierdomenico SD, Pierdomenico AM, Cuccurullo F. Meta-analysis of the relation of echocardiographic epicardial adipose tissue thickness and the metabolic syndrome. Am J Cardiol. 2013; 111 (1):73–8.

22. Bachar GN, Dicker D, Kornowski R. Epicardial adipose tissue as a predictor of coronary artery disease in asymptomatic subjects.Am J Cardiol. 2012; 110 (4):534–8.


Review

For citations:


Veselovskaya N.G., Chumakova G.A., Ott A.V., Gritsenko O.V. A NON-INVASIVE MARKER OF INSULIN RESISTANCE IN PATIENTS WITH OBESITY. Russian Journal of Cardiology. 2013;(6):28-32. (In Russ.) https://doi.org/10.15829/1560-4071-2013-6-28-32

Views: 684


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 1560-4071 (Print)
ISSN 2618-7620 (Online)