Objectives: Cardiovascular disease (CVD) is the leading cause of death in adults with type 1 diabetes mellitus (T1D) and risk factors for CVD are present early in the disease course. Epicardial adipose thickness (EAT) , a novel independent marker of CVD, is significantly increased in children with T1D compared to healthy controls. Obesity, a known CVD risk factor, is increasingly prevalent in the pediatric population and may confer additional risk in youth with T1D. The purpose of this study was to examine EAT in overweight/obese pediatric patients with T1D.
Methods: This was a single-center, cross-sectional study of 37 youth with T1D and BMI > 85th percentile (BMI percentile=93.1±4.3, age 13.5y±3.4, 62.1% female) . Waist circumference, blood pressure, HbA1C and a 2D echocardiogram measuring EAT were obtained. Insulin resistance was calculated via estimated glucose disposal rate (eGDR) .
Results: EAT was correlated with age (r=0.45, P=0.006) , BMI (r=0.58, P=0.0001) , waist circumference (r=0.64, P=0.0001) , and diastolic BP (r=0.37, P=0.023) , while inversely correlated with eGDR (r=-0.49, P 0.002) and most recent HDL level (r=-0.43, P=0.027) . There were no significant correlations between EAT and HbA1C (r=-0.01, P=0.9) or duration of diabetes (r=0.16, P=0.4) . After multivariate regression analysis, age and BMI were independent predictors explaining 43.7% of the variance in EAT (P=0.001) .
Conclusions: EAT is associated with measures of adiposity and CVD risk, however, only age and BMI were independent predictors of EAT among overweight and obese youth with T1D. In addition to a focus on tight glycemic control to prevent CVD in overweight and obese youth with T1D, further studies are needed to investigate the impact of BMI lowering interventions on EAT.
L.Cielonko: None. M.Olson: None. A.A.Sabati: None. M.Chambers: None. D.Newbern: None. V.Chakravarthy: None. J.Schmidt: None. J.Mullen: None. N.Lutz: None. G.Q.Shaibi: None.