STUDY OF ASSOCIATION BETWEEN EPICARDIAL FAT ADIPOCYTE SIZE, INSULIN RESISTANCE, ADIPOCYTOKINE LEVELS AND BODY COMPOSITION IN DIABETIC AND NON DIABETIC PATIENTS
Authors: Gupta Richa , Yadav Kamlesh , Priya Nidhi 
Published: September 2023

Introduction : Diabetes mellitus is one of the most common metabolic diseases worldwide. Adipose tissue is not only a lipid storage unit, but it also
functions as a paracrine and endocrine organ, secreting a number of adipocytokines such as leptin, adiponectin and tumor necrosis factor-α (TNF-α) etc.
Abnormally accumulated visceral fat is a risk factor for insulin resistance. Epicardial adipose tissue (EAT) is a visceral adipose tissue that surrounds the
myocardium and pericardium. It has recently been shown that enlargement of the adipocytes is an independent marker of insulin resistance. Larger
adipocytes release higher amounts of proinammatory mediators such as leptin and resistin, and lower amounts of adiponectin. Little is known about
EAT cellularity. We aim to investigate EAT adipocyt Objective/Aim: e size and its relationship with insulin resistance, circulating levels of
adipocytokines, and body composition in Diabetic and Non Diabetic patients, in order to achieve a better insight into the physiology of epicardial
adiposity. A one-year Single centre,hospital based compa Materials and Methods: rative cross-sectional study conducted in 40 diabetic & 40 nondiabetic patients undergoing Cardiac surgery at CTVS Department of S.M.S.Hospital, Jaipur. Written explained informed consent were taken from all
recruited patients. Fasting peripheral venous sample were collected for basic laboratory investigations. Radiological Assessment in form of MRI
abdomen was done to determine abdominal subcutaneous and visceral fat percentage. Cardiac 2D echo was done for epicardial fat quantication.
Epicardial adipose tissue was obtained by the operating surgeon in patients undergoing Cardiac surgery in vial containing Formalin. H &E stained slides
were then examined under microscope. Pictures on 10x and 40x zoom were clicked and cell size measurements were taken. Statistical analyses were
done using Medcalc 19.4 version for all statistical calculation Most of the study population was elder Results: ly & Smoking & alcohol was observed
more in Diabetics. W:H ratio in diabetic group cases was signicantly higher as compared to non diabetic group cases showing that central obesity was
more related with diabetics. Epicardial fat thickness was more in diabetics compared to non-diabetics…although Epicardial fat adipocyte size was
found to be more in Non-diabetics. Signicant diff Conclusion: erence with respect to W:H ratio shows role of central obesity in diabetics. Causal
association of smoking and alcohol to diabetes may be considered. We concluded that epicardial fat thickness increases and adipocyte size decreases in
diabetics which may be due to proliferation of smaller adipocytes, showing its association with insulin resistance, adipocytokine levels and body
composition. As now a days routine health check up is recommended for all middle age and elderly persons, we feel(on the basis of this study) that EAT
thickness must be measured while doing 2D-Echo and insulin resistance must be determined so that persons at risk of developing diabetes & potential
CVD patients can be picked up at an early stage & their complications can be prevented.