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World J Diabetes. 2020 Feb 15;11(2):33-41. doi: 10.4239/wjd.v11.i2.33.

Epicardial adipose tissue deposition in patients with diabetes and renal impairment: Analysis of the literature.

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School of Medicine, European University Cyprus, Nicosia 2404, Cyprus.
Diabetes and Obesity Center, Konstantopouleio Hospital, Athens 14233, Greece.
School of Medicine, European University Cyprus, Nicosia 2404, Cyprus.


Diabetes mellitus (DM) is defined as a chronic disease of disordered metabolism with an ongoing increase in prevalence and incidence rates. Renal disease in patients with diabetes is associated with increased morbidity and premature mortality, particularly attributed to their very high cardiovascular risk. Since this group of patients frequently lacks specific symptomatology prior to the adverse events, a screening tool for the identification of high-risk patients is necessary. The epicardial adipose tissue (EAT) is a biologically active organ having properties similar to visceral adipose tissue and has been associated with metabolic diseases and coronary artery disease. Superior to conventional cardiovascular risk factors and anthropometric measures, including body mass index and waist circumference, the EAT can early predict the development of coronary artery disease. Assessment of EAT can be performed by two-dimensional echocardiography, magnetic resonance imaging or computer tomography. However, its role and significance in patients with DM and nephropathy has not been thoroughly evaluated. The aim of the current editorial is to evaluate all available evidence regarding EAT in patients with DM and renal impairment. Systematic search of the literature revealed that patients with DM and nephropathy have increased EAT measurements, uncontrolled underlying disease, high body mass index and raised cardiovascular risk markers. Acknowledging the practical implications of this test, EAT assessment could serve as a novel and non-invasive biomarker to identify high-risk patients for cardiovascular adverse events.


Cardiovascular risk; Diabetes mellitus; Diabetic nephropathy; Epicardial adipose tissue; Epicardial fat; Renal impairment

Conflict of interest statement

Conflict-of-interest statement: The authors have no conflicts of interest to declare.

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