TABLE 1.
Studies based on imaging techniques exploring the association between EAT, metabolic disorders, and CVDs.
| Study | Year | Study design | Study population and sample size | Method | Major findings |
|---|---|---|---|---|---|
| Wang et al. 80 | 2009 | Cross sectional | T2DM patients (n = 49); nondiabetic patients (n = 78) | CT: EAT volume |
EAT volume was higher in T2DM patients than nondiabetic patients. EAT volume was associated with unfavorable components of MetS and coronary atherosclerosis. |
| Tonbul et al. 81 | 2011 | Cross sectional | End‐stage renal disease (ESRD) patients: T2DM (n = 17); nondiabetic (n = 43) | CT: EAT volume | EAT volume was higher in ESRD patients with T2DM than those without T2DM. |
| Cetin et al. 197 | 2013 | Cross sectional | T2DM patients (n = 139); nondiabetic patients (n = 40) | Echocardiography: EAT thickness |
EAT thickness was higher in T2DM patients than nondiabetic patients. EAT thickness was significantly associated with waist circumference and carotid intima‐media thickness. |
| Yorgun et al. 84 | 2013 | Cross sectional | MetS patients: (n = 40); non‐MetS patients: (n = 43) | CT: EAT thickness | EAT thickness was higher in MetS patients than non‐MetS patients. |
| Mun˜oz et al. 198 | 2014 | Cross sectional | Postmenopausal women: MetS (n = 14); non‐MetS (n = 20) | Echocardiography: EAT thickness |
EAT thickness was higher in postmenopausal women with MetS than those without MetS. EAT thickness was positively correlated with visceral adipose tissue, BMI, waist circumference in postmenopausal women. |
| Akbas et al. 199 | 2014 | Cross sectional | T2DM patients (n = 156); nondiabetic patients (n = 50) | Echocardiography: EAT thickness |
EAT thickness was higher in T2DM patients than nondiabetic patients. EAT thickness was positively correlated with waist circumference and platelet‐to‐lymphocyte ratio in T2DM patients. |
| Groves et al. 82 | 2014 | Cross sectional | Asymptomatic T2DM patients without known CAD (n = 92); asymptomatic nondiabetic patients (n = 270) | CT: EAT volume |
EAT volume was higher in T2DM patients than nondiabetic patients. EAT was an independent predictor of the incidence and severity of CAD. |
| Song et al. 77 | 2015 | Cross sectional | 94 Patients (40 with T2DM, 50 with obesity) | CT: EAT thickness and epicardial fat area (EFA) measured at the level of left main coronary artery |
EAT thickness and EFA was higher in T2DM patients than nondiabetic patients. EAT thickness and EFA was higher in obese patients than nonobese patients. |
| Kaya et al. 200 | 2015 | Cross sectional | Geriatric patients: MetS (n = 30); non‐MetS (n = 30) | Echocardiography: EAT thickness | EAT thickness was higher in geriatric MetS patients than non‐Met patients. |
| Evin et al. 91 | 2016 | Cross sectional | Patients with obesity and T2DM (n = 20); healthy controls without obesity or T2DM (n = 19) | MRI: EAT volume | EAT volume was higher in patients with obesity and T2DM than healthy controls. |
| Christensen et al. 85 | 2017 | Prospective | Patients with T2DM and elevated urinary albumin excretion rate (UAER) (n = 200) | Echocardiography: EAT thickness | Increased EAT thickness was associated with increased risk of incident CVDs or all‐cause mortality in patients with T2DM and elevated UAER. |
| Chen et al. 201 | 2017 | Cross sectional | T2DM patients (n = 167); nondiabetic patients (n = 82) | Echocardiography: EAT thickness |
EAT thickness was higher in T2DM patients than nondiabetic patients. EAT thickness was independently associated with serum 25‐hydroxyvitamin D and HOMA‐IR. |
| Seker et al. 202 | 2017 | Prospective | Patients with non‐ST elevation myocardial infarction: T2DM (n = 186); nondiabetic: (n = 268) | Echocardiography: EAT thickness |
EAT thickness was higher in T2DM patients than nondiabetic patients. EAT thickness was independently associated with extent and complexity of CAD (evaluated by SYNTAX score). |
| Wang et al. 203 | 2017 | Cross sectional | T2DM patients (n = 68); nondiabetic patients (n = 30) | Echocardiography: EAT thickness |
EAT thickness was higher in T2DM patients than nondiabetic patients. EAT thickness was significantly associated with intimal medial thickness of carotid artery. |
| Kang et al. 83 | 2018 | Retrospective | Patients with CAD treated with high‐intensity statins (n = 321) | Echocardiography: EAT thickness | Epicardial adipose tissue thickness is a consistent independent predictor of new‑onset T2DM in patients with CAD treated with high‐intensity statins. |
| Christensen et al. 86 | 2019 | Prospective | T2DM patients (n = 1030) | Echocardiography: EAT thickness | High levels of EAT were associated with increased incident CVD and mortality in patients with T2DM. |
| Lin et al. 58 | 2021 | Prospective | MetS patients (n = 280); non‐MetS patients (n = 1788) | CT: EAT volume and EAT attenuation | EAT thickness was higher and EAT attenuation was lower in MetS patients than non‐MetS patients. |
| Ichikawa et al. 204 | 2022 | Prospective | T2DM patients (n = 333) | CT: LAD‐PCAT attenuation | LAD‐PCAT attenuation was significantly higher in patients with cardiovascular events than in those without. |
Abbreviations: CAD, coronary artery disease; EAT, epicardial adipose tissue; ESRD, end‐stage renal disease; LAD, left anterior descending coronary artery; MetS, metabolic syndrome; PCAT, paracardial adipose tissue.; T2DM, type 2 diabetes mellitus.