Editorial
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Feb 15, 2020; 11(2): 33-41
Published online Feb 15, 2020. doi: 10.4239/wjd.v11.i2.33
Epicardial adipose tissue deposition in patients with diabetes and renal impairment: Analysis of the literature
Zoi Kleinaki, Aris P Agouridis, Maria Zafeiri, Theodoros Xanthos, Constantinos Tsioutis
Zoi Kleinaki, Aris P Agouridis, Theodoros Xanthos, Constantinos Tsioutis, School of Medicine, European University Cyprus, Nicosia 2404, Cyprus
Maria Zafeiri, Diabetes and Obesity Center, Konstantopouleio Hospital, Athens 14233, Greece
Author contributions: Kleinaki Z conceptualized and designed the study, participated in data acquisition, extraction and interpretation, prepared tables, wrote and drafted the initial manuscript and approved the final manuscript as submitted; Agouridis AP participated in data analysis and interpretation, reviewed and revised the manuscript and approved the final manuscript as submitted; Zafeiri M conceptualized the study, participated in data interpretation, reviewed and revised the initial manuscript and approved the final manuscript as submitted; Xanthos T participated in data interpretation, reviewed and revised the initial manuscript and approved the final manuscript as submitted; Tsioutis C conceptualized and designed the study, participated in data acquisition, interpreted the data, wrote and drafted the initial manuscript, reviewed and revised the manuscript and approved the final manuscript as submitted.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Constantinos Tsioutis, MD, PhD, Lecturer, School of Medicine, European University Cyprus, 6 Diogenes Street, Nicosia 2404, Cyprus. kostsioutis@gmail.com
Received: September 3, 2019
Peer-review started: August 28, 2018
First decision: October 9, 2018
Revised: December 11, 2019
Accepted: December 14, 2019
Article in press: December 14, 2019
Published online: February 15, 2020
Processing time: 126 Days and 14.9 Hours
Abstract

Diabetes mellitus (DM) is defined as a chronic disease of disordered metabolism with an ongoing increase in prevalence and incidence rates. Renal disease in patients with diabetes is associated with increased morbidity and premature mortality, particularly attributed to their very high cardiovascular risk. Since this group of patients frequently lacks specific symptomatology prior to the adverse events, a screening tool for the identification of high-risk patients is necessary. The epicardial adipose tissue (EAT) is a biologically active organ having properties similar to visceral adipose tissue and has been associated with metabolic diseases and coronary artery disease. Superior to conventional cardiovascular risk factors and anthropometric measures, including body mass index and waist circumference, the EAT can early predict the development of coronary artery disease. Assessment of EAT can be performed by two-dimensional echocardiography, magnetic resonance imaging or computer tomography. However, its role and significance in patients with DM and nephropathy has not been thoroughly evaluated. The aim of the current editorial is to evaluate all available evidence regarding EAT in patients with DM and renal impairment. Systematic search of the literature revealed that patients with DM and nephropathy have increased EAT measurements, uncontrolled underlying disease, high body mass index and raised cardiovascular risk markers. Acknowledging the practical implications of this test, EAT assessment could serve as a novel and non-invasive biomarker to identify high-risk patients for cardiovascular adverse events.

Keywords: Epicardial adipose tissue; Epicardial fat; Diabetes mellitus; Renal impairment; Diabetic nephropathy; Cardiovascular risk

Core tip: The epicardial adipose tissue (EAT) is a biologically active organ and has been associated with metabolic diseases and coronary artery disease. EAT is a superior cardiovascular risk factor compared to conventional measures. This editorial evaluates the reported measurements of EAT in patients with diabetes mellitus and renal impairment, along with their clinical and laboratory characteristics. Patients with diabetes mellitus and nephropathy have increased EAT volume, uncontrolled disease, high body mass index and raised cardiovascular risk markers, when compared with healthy population. Based on current literature, EAT assessment could be used as a novel biomarker for the identification of patients at high risk for cardiovascular adverse events.