Type 1 diabetes (T1D) and menopause are associated with higher risk of coronary artery calcium (CAC). Accumulation of pericardial adipose tissue (PAT), a pro-inflammatory visceral fat higher in post-menopausal women and associated with increased CAC, may be a mechanism by which T1D is associated with higher CAC risk. We examined the effect of PAT on the relationship between T1D and CAC in women over time.
PAT and CAC volume data were collected from CT heart scans over 4 study visits from 725 women enrolled in the Coronary Artery Calcification in Type 1 Diabetes (CACTI) study (mean baseline age ± SD, 37 ± 9 years). We used repeated measures modeling to examine changes in square root-transformed CAC volume over time by T1D, menopausal status, and quartile of PAT volume after adjusting for age, central obesity, and study visit.
PAT levels did not differ by T1D status (33.5 vs. 33.7, p=0.8), but there was a significant interaction between PAT, menopause, and T1D (p=0.02) in relation to CAC volume (Figure 1). In T1D women, higher PAT was associated with higher CAC volume regardless of menopause status, but the effect was greater in post-menopausal women. There was no difference in CAC in nondiabetic (non-DM) women across PAT quartiles or by menopause status. CAC was higher in T1D than non-DM women regardless of menopause status and PAT quartile.
PAT has a greater effect on CAC in women with T1D than non-DM women, despite similar PAT volumes.
A. Keshawarz: None. L. Pyle: None. A.C. Alman: None. C. Sassano: None. E. Westfeldt: None. R.M. Sippl: None. J.K. Snell-Bergeon: Stock/Shareholder; Self; Abbott. Research Support; Self; Roche Diagnostics Corporation.