Associations between cardiac adipose tissue volume, measures of coronary calcification, myocardial microvascular function and systemic inflammation in individuals with type 2 diabetes free of overt cardiovascular disease.
13 affiliations
- 1Steno Diabetes Center Copenhagen, Borgmester Ib Juuls Vej 83, 2730, Herlev, Denmark.
- 2Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.
- 3Department of Cardiology, Herlev & Gentofte Hospital, Hellerup, Denmark.
- 4Department of Internal Medicine 1, Holbæk Hospital, Holbæk, Denmark.
- 5Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
- 6Department of Medicine, Zealand University Hospital, Nykøbing Falster, Denmark.
- 7Steno Diabetes Center Zealand, Zealand, Denmark.
- 8Department of Medicine, Zealand University Hospital, Køge, Denmark.
- 9Department of Cardiology, Rigshospitalet, Denmark.
- 10Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital - Bispebjerg, Copenhagen, Denmark.
- 11Cluster for Molecular Imaging, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark.
- 12Steno Diabetes Center Copenhagen, Borgmester Ib Juuls Vej 83, 2730, Herlev, Denmark. [email protected].
- 13Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark. [email protected].
Abstract
Background
Peri- and epicardial adipose tissue (PEAT) is a metabolically active fat depot surrounding the heart and coronary arteries that may contribute to vascular dysfunction and inflammation in type 2 diabetes (T2D). We examined associations between PEAT volume, coronary calcification (CACS), myocardial flow reserve (MFR), and systemic inflammation (hsCRP).Methods
Cross-sectional analysis of adults with T2D without overt CVD recruited 2020-2023. PEAT was quantified on non-contrast CT; CACS was calculated by the Agatston method; MFR was measured by rubidium-82 PET/CT; hsCRP assessed systemic inflammation. Associations were tested using multivariable regression adjusting for cardiovascular risk factors.Results
Among 887 participants (mean age 65 years; 70% male; mean BMI 30 kg/m²; median PEAT 199 mL [IQR 133-283]), higher PEAT (per 100 mL) was associated with lower MFR (β - 0.04; 95% CI - 0.09 to 0.00; p = 0.041) and higher hsCRP, corresponding to a 38% increase (95% CI 28% to 48%; p < 0.001) in age- and sex-adjusted models, but not with CACS > 300 (OR 1.01; 95% CI 0.89-1.15). After further adjustment for diabetes duration, BMI, LDL cholesterol, systolic blood pressure, HbA1c, kidney function, smoking, and albuminuria, only the association with hsCRP remained significant at 14% (95%; CI 4% to 25%; p = 0.005).Conclusion
In individuals with T2D without overt CVD, PEAT volume was not independently associated with CACS or MFR after multivariable adjustment. Higher PEAT volume was associated with higher hsCRP, suggesting a relationship with systemic inflammation; however, this exploratory finding should be interpreted in the context of established links between adiposity and inflammatory burden.
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BibTeX
@article{jensen2026associations,
title = {{Associations between cardiac adipose tissue volume, measures of coronary calcification, myocardial microvascular function and systemic inflammation in individuals with type 2 diabetes free of overt cardiovascular disease.}},
author = {Morten Steen Jensen and Ida K B Rasmussen and Anne-Cathrine Skriver-Møller and Philip Hasbak and Martin B Blond and Adam Chebli and Victor S Wasehuus and Mats C H Lassen and Morten Lindhardt and Allan Kofoed-Enevoldsen and Urd L Kielgast and Emilie H Zobel and Lene Holmvang and Tor Biering-Sørensen and Peter Rossing and Rasmus S Ripa and Andreas Kjaer and Tine W Hansen},
journal = {Cardiovascular diabetology},
year = {2026},
month = jul,
doi = {10.1186/s12933-026-03298-7},
url = {https://europepmc.org/article/MED/42897624},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Associations between cardiac adipose tissue volume, measures of coronary calcification, myocardial microvascular function and systemic inflammation in individuals with type 2 diabetes free of overt cardiovascular disease.
AU - Morten Steen Jensen
AU - Ida K B Rasmussen
AU - Anne-Cathrine Skriver-Møller
AU - Philip Hasbak
AU - Martin B Blond
AU - Adam Chebli
AU - Victor S Wasehuus
AU - Mats C H Lassen
AU - Morten Lindhardt
AU - Allan Kofoed-Enevoldsen
AU - Urd L Kielgast
AU - Emilie H Zobel
AU - Lene Holmvang
AU - Tor Biering-Sørensen
AU - Peter Rossing
AU - Rasmus S Ripa
AU - Andreas Kjaer
AU - Tine W Hansen
PY - 2026
DA - 2026/07/01
JO - Cardiovascular diabetology
DO - 10.1186/s12933-026-03298-7
UR - https://europepmc.org/article/MED/42897624
AB - Background Peri- and epicardial adipose tissue (PEAT) is a metabolically active fat depot surrounding the heart and coronary arteries that may contribute to vascular dysfunction and inflammation in type 2 diabetes (T2D). We examined associations between PEAT volume, coronary calcification (CACS), myocardial flow reserve (MFR), and systemic inflammation (hsCRP).Methods Cross-sectional analysis of adults with T2D without overt CVD recruited 2020-2023. PEAT was quantified on non-contrast CT; CACS was calculated by the Agatston method; MFR was measured by rubidium-82 PET/CT; hsCRP assessed systemic inflammation. Associations were tested using multivariable regression adjusting for cardiovascular risk factors.Results Among 887 participants (mean age 65 years; 70% male; mean BMI 30 kg/m²; median PEAT 199 mL [IQR 133-283]), higher PEAT (per 100 mL) was associated with lower MFR (β - 0.04; 95% CI - 0.09 to 0.00; p = 0.041) and higher hsCRP, corresponding to a 38% increase (95% CI 28% to 48%; p < 0.001) in age- and sex-adjusted models, but not with CACS > 300 (OR 1.01; 95% CI 0.89-1.15). After further adjustment for diabetes duration, BMI, LDL cholesterol, systolic blood pressure, HbA1c, kidney function, smoking, and albuminuria, only the association with hsCRP remained significant at 14% (95%; CI 4% to 25%; p = 0.005).Conclusion In individuals with T2D without overt CVD, PEAT volume was not independently associated with CACS or MFR after multivariable adjustment. Higher PEAT volume was associated with higher hsCRP, suggesting a relationship with systemic inflammation; however, this exploratory finding should be interpreted in the context of established links between adiposity and inflammatory burden.
SN - 1475-2840
ER -