Email updates

Keep up to date with the latest news and content from Cardiovascular Diabetology and BioMed Central.

Open Access Highly Accessed Original investigation

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

Kazuhiro Osawa1, Toru Miyoshi2*, Yasushi Koyama3, Shuhei Sato4, Noriaki Akagi4, Yusuke Morimitsu4, Motoki Kubo1, Hiroki Sugiyama1, Kazufumi Nakamura1, Hiroshi Morita2, Susumu Kanazawa4 and Hiroshi Ito1

Author Affiliations

1 Department of Cardiovascular Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama, Japan

2 Department of Cardiovascular Therapeutics, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, 2-5-1 Shikata-cho, Okayama 700-8558, Japan

3 Cardiovascular Center, Sakurabashi Watanabe Hospital, Osaka, Japan

4 Department of Radiology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama, Japan

For all author emails, please log on.

Cardiovascular Diabetology 2014, 13:61  doi:10.1186/1475-2840-13-61

Published: 14 March 2014

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:
Visceral adipose tissue; Coronary artery disease; Diabetes mellitus