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Journal of Clinical Endocrinology & Metabolism, doi:10.1210/jc.2005-1087
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The Journal of Clinical Endocrinology & Metabolism Vol. 90, No. 11 6300-6302
Copyright © 2005 by The Endocrine Society

BRIEF REPORT

Epicardial Adipose Tissue and Insulin Resistance in Obese Subjects

Gianluca Iacobellis and Frida Leonetti

Endocrinology, Department of Clinical Sciences, La Sapienza University, 00161 Rome, Italy

Address all correspondence and requests for reprints to: Dr. Gianluca Iacobellis, Dipartimento di Scienze Cliniche, Policlinico Umberto I, Viale del Policlinico 155, 00161 Rome, Italy. E-mail: gianluca.iaco{at}tin.it.

Context: Epicardial adipose tissue has been recently recognized as a source of bioactive molecules as well as free fatty acids, adiponectin, and inflammatory cytokines. Epicardial fat reflects intraabdominal visceral fat, and the echocardiographic assessment of this tissue is an easy and reliable marker of visceral adiposity.

Objective: In this study we evaluated whether epicardial adipose tissue is related to insulin sensitivity and glucose metabolism in obese subjects.

Patients: Thirty obese subjects (20 women and 10 men; mean age, 40.8 ± 11.5 yr; body mass index, 43 ± 9.1 kg/m2) were included in this study. No subject was taking drugs or had a history or evidence of metabolic, cardiovascular, respiratory, or hepatic disease.

Main Outcome Measures: Each subject underwent a transthoracic echocardiogram to evaluate epicardial adipose tissue thickness, a euglycemic hyperinsulinemic clamp to estimate insulin sensitivity, and an oral glucose tolerance test to evaluate glucose tolerance.

Results: The thickness of the epicardial adipose tissue on the right ventricle varied between 4 and 17.4 mm. Echocardiographic epicardial adipose tissue was significantly correlated with whole-body glucose uptake index from the clamp and with all indices of insulin resistance and glucose intolerance measured, except the 120-min plasma glucose level after an oral glucose tolerance test.

Conclusions: Our study showed that the epicardial fat is significantly related to obesity-related insulin resistance. This finding could be of potential interest in clinical practice and research of obesity-related risk stratification.




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