Subscribe to RSS
Fetal Epicardial Fat Thickness: Its Role as Marker for Gestational Diabetic Mellitus
Background There are very few studies on the association between fetal epicardial fat thickness (EFT) and gestational diabetes mellitus (GDM).
Aims To evaluate the role of fetal epicardial fat thickness as a marker and use it in pregnancies to screen for GDM.
Settings and Design A cross-sectional analytical study was conducted in the Department of Radiodiagnosis and Imaging at Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, after the due clearance from the institutional research and ethics committee.
Materials and Methods The study included pregnant patients at 24 + 0/6 to 28 + 0/6 weeks of gestation scheduled for a 75 g oral glucose tolerance test from December 1, 2020 to March 30, 2022. Antenatal ultrasound was performed on Voluson E8 Expert BT12 (Wipro GE) ultrasound machine. Out of 180 patients, 60 patients were selected, that is, 30 patients with raised 75 g OGTT results (cases of GDM) and 30 patients with normal 75 g OGTT results.
Statistical Analysis The collected data were transformed into variables, coded, and entered into Microsoft Excel. Data were analyzed using the Shapiro–Wilk normality test, student's t-test or Mann–Whiney U test, chi-square test, or Fisher's exact test and statistically evaluated using the SPSS-PC-25 version.
Results Fetal EFT was found to be significantly more in the GDM group in comparison to controls without GDM, and the increased fetal EFT was positively associated with 2-hour OGTT serum glucose values.
The mean fetal epicardial fat thickness (EFT) in mothers with GDM was significantly larger, i.e., 0.17 ± 0.02 cm than in mothers without GDM, i.e., 0.12 ± 0.01 cm (p < 0.001). The receiver operating characteristic (ROC) curve plotted from values calculated from our results shows high sensitivity (i.e., 96.67%) and specificity (i.e., 90%) of fetal EFT as a predictor for GDM with an AUROC value of 0.96 and 95% confidence interval of 0.92 to 1.0.
Conclusions EFT was significantly higher in fetuses of diabetic versus nondiabetic mothers. The mean difference in EFT of GDM cases and controls was relatively small but was statistically significant. The study concluded that measuring the epicardial fat thickness in fetuses can serve as a novel marker in GDM.
Article published online:
04 March 2023
© 2023. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India
- 1 Nelson AJ, Worthley MI, Psaltis PJ. et al. Validation of cardiovascular magnetic resonance assessment of pericardial adipose tissue volume. J Cardiovasc Magn Reson 2009; 11 (01) 15
- 2 Sacks HS, Fain JN. Human epicardial adipose tissue: a review. Am Heart J 2007; 153 (06) 907-917
- 3 Bertaso AG, Bertol D, Duncan BB, Foppa M. Epicardial fat: definition, measurements and systematic review of main outcomes. Arq Bras Cardiol 2013; 101 (01) e18-e28
- 4 Iacobellis G, Barbaro G. The double role of epicardial adipose tissue as pro- and anti-inflammatory organ. Horm Metab Res 2008; 40 (07) 442-445
- 5 Cetin M, Cakici M, Polat M, Suner A, Zencir C, Ardic I. Relation of epicardial fat thickness with carotid intima-media thickness in patients with type 2 diabetes mellitus. Int J Endocrinol 2013; 2013: 769175
- 6 American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care 2009; 32 (Suppl 1) S62-S67
- 7 Noussitou P, Monbaron D, Vial Y, Gaillard RC, Ruiz J. Gestational diabetes mellitus and the risk of metabolic syndrome: a population-based study in Lausanne, Switzerland. Diabetes Metab 2005; 31 (4 Pt 1): 361-369
- 8 König AB, Junginger S, Reusch J, Louwen F, Badenhoop K. Gestational diabetes outcome in a single center study: higher BMI in children after six months. Horm Metab Res 2014; 46 (11) 804-809
- 9 Asemi Z, Karamali M, Esmaillzadeh A. Favorable effects of vitamin D supplementation on pregnancy outcomes in gestational diabetes: a double blind randomized controlled clinical trial. Horm Metab Res 2015; 47 (08) 565-570
- 10 Drynda R, Peters CJ, Jones PM, Bowe JE. The role of non-placental signals in the adaptation of islets to pregnancy. Horm Metab Res 2015; 47 (01) 64-71
- 11 Jackson D, Deschamps D, Myers D, Fields D, Knudtson E, Gunatilake R. Fetal epicardial fat thickness in diabetic and non-diabetic pregnancies: A retrospective cross-sectional study. Obesity (Silver Spring) 2016; 24 (01) 167-171
- 12 Yavuz A, Akkurt MO, Yalcin S, Karakoc G, Varol E, Sezik M. Second trimester fetal and maternal epicardial fat thickness in gestational diabetic pregnancies. Horm Metab Res 2016; 48 (09) 595-600
- 13 Akkurt MO, Turan OM, Crimmins S, Harman CR, Turan S. Increased fetal epicardial fat thickness: a novel ultrasound marker for altered fetal metabolism in diabetic pregnancies. J Clin Ultrasound 2018; 46 (06) 397-402
- 14 Chun H, Suh E, Byun AR, Park HR, Shim KW. Epicardial fat thickness is associated to type 2 diabetes mellitus in Korean men: a cross-sectional study. Cardiovasc Diabetol 2015; 14: 46
- 15 Iacobellis G, Willens HJ. Echocardiographic epicardial fat: a review of research and clinical applications. J Am Soc Echocardiogr 2009; 22 (12) 1311-1319 , quiz 1417–1418
- 16 Iacobellis G, Barbaro G, Gerstein HC. Relationship of epicardial fat thickness and fasting glucose. Int J Cardiol 2008; 128 (03) 424-426
- 17 Aydin S, Fatihoglu E. Fetal epicardial fat thickness: can it serve as a sonographic screening marker for gestational diabetes mellitus?. J Med Ultrasound 2020; 28 (04) 239-244
- 18 Mookadam F, Goel R, Alharthi MS, Jiamsripong P, Cha S. Epicardial fat and its association with cardiovascular risk: a cross-sectional observational study. Heart Views 2010; 11 (03) 103-108