Correlation Between Epicardial Fatty Tissue Thickness And Diabetes Mellitus Associated With Atrial Fibrillation

Objective EAT(epicardial adipose tissue)is a special type of VAT(visceral adipose tissue),and related studies have shown that EAT is closely associated with atrial fibrillation and diabetes,but EAT thickness and the occurrence of atrial fibrillation in diabetic patients are not clear.In this study,the difference in EAT thickness between diabetic patients with combined atrial fibrillation and diabetic patients with sinus rhythm and sinus rhythm was observed and investigated to provide a new target for intervention and treatment of diabetic patients with atrial fibrillation.MethodsIn this study,a cross-sectional survey methodology has been used.Patients who were hospitalized in the Department of Cardiovascular Medicine of the Affiliated Hospital of Yangzhou University from June 1,2022 to October 31,2022 and met the enrollment criteria were selected,including 30 patients in the diabetic atrial fibrillation group,30 patients in the diabetic sinus rhythm group,and 30 patients in the sinus rhythm group.During the patient’s hospitalization,general clinical information,initial biochemical indices,ECG and cardiac ultrasound are collected;Multislice computed tomography(MSCT)measurement of EAT thickness in the right coronary region of the AV sulcus,left coronary region of the AV sulcus,left ventricular apical region,and right ventricular free wall(measurements averaged at 25%,50%,and 75%);Serum leptin and lipocalin concentrations were measured by enzyme-linked immunosorbent assay(ELISA).All collected data were statistically analyzed using SPSS 27.0 statistical software,and measurement data were expressed as X+s for those conforming to a normal distribution and median+M(P25,P75)for those not conforming to a normal distribution;count data were expressed as rates(%).Comparisons between multiple groups: one-way ANOVA was used for measurement data that followed a normal distribution with equal variance in each group;comparisons between two groups: independent samples t-test was used for comparison between groups for measurement data that followed a normal distribution,and chi-squared test was used for count data.Logistic regression was used to analyze the relative risk factors of diabetes mellitus combined with atrial fbrillation.Two groups of variables were analyzed for correlation,and measures that followed a normal distribution were analyzed by Pearson analysis.ROC curves were plotted to evaluate the sensitivity and specificity of epicardial fat thickness for diabetic AF.Differences were considered statistically significant at P<0.05.Results1.EAT thickness in the right coronary area of the atrioventricular sulcus,left coronary area of the atrioventricular sulcus,and right ventricular free wall was greater in the diabetic sinus rhythm group compared with the sinus rhythm group and was statistically significant(P<0.05);the fat factor between the two groups was not statistically significant.2.Compared with the diabetic atrial fibrillation group and the diabetic sinus rhythm group,the results of binary one-way logistic regression analysis suggested that age,prevalence of heart failure,fasting glucose,TG(triglyceride),apo A1(apolipoprotein A1),apo B(apolipoprotein B),NT-pro-BNP(N-terminal fragment brain natriuretic peptide),lipocalin,left atrial sulcus area,and left ventricular apical EAT were risk factors for the development of AF in diabetic patients(P < 0.05).After correction for confounders,the results of multifactorial logistic regression analysis suggested that the prevalence of heart failure,fasting glucose,APOB,and lipocalin were independent risk factors for the development of AF in diabetes mellitus(P < 0.05).3.Diabetic patients were divided into four groups according to EAT thickness values.EAT thickness in the left coronary region of the atrioventricular sulcus and the left ventricular apical region correlated with the prevalence of atrial fibrillation in diabetic patients,with an increased prevalence of atrial fibrillation in the high and very high EAT thickness groups compared with the low and medium groups.4.Diabetic patients were divided into four groups based on serum adipokine lipocalin concentrations,with the high and very high groups having a higher prevalence of AF compared with the low and medium groups.5.Correlation analysis showed no significant correlation between EAT thickness in the left coronary area of the atrioventricular sulcus and serum adipokines: leptin,lipocalin,and hs-CRP(high-sensitivity C-reactiveprotein).ConclusionCompared with the diabetic sinus rhythm group,the diabetic AF group had significantly greater EAT thickness in the right coronary area of the atrioventricular sulcus,the left coronary area of the atrioventricular sulcus,and the right ventricular free wall;adipokine lipocalin was an independent risk factor for the development of atrial fibrillation in the diabetic population;and the prevalence of atrial fibrillation was higher in the high and very high EAT groups compared with the low and intermediate EAT groups in diabetic patients.