Visceral abdominal adipose tissue and coronary atherosclerosis in asymptomatic diabetics

Alla Khashper, Tamar Gaspar, Mali Azencot, Idit Dobrecky-Mery, Nathan Peled, Basil S. Lewis, David A. Halon

Research output: Contribution to journalArticlepeer-review

20 Scopus citations


Background: Visceral abdominal adipose tissue (VAT) may play an active role in the progression of coronary atherosclerosis. We examined the relation between VAT, non-alcoholic fatty liver disease and extent of coronary atheroma in patients with type 2 diabetes mellitus but no known coronary artery disease. Methods: Coronary artery calcium and area, distribution and thickness of upper abdominal fat were measured in selected axial cross-sections from non-enhanced computed tomography (CT) scans of the chest. Coronary atheroma was assessed visually on a per vessel basis from 64 slice CT angiography using axial views and multi-format reconstructions. Fatty liver was diagnosed when liver density was < 40 Hounsfield units (HU) or ≥ 10 HU below spleen density. Results: The area of VAT was increased in patients with versus without multi-vessel coronary artery plaque (237.0 ± 101.4 vs 179.2 ± 79.4 mm 2, p < 0.001). Waist circumference (101.6 ± 12.3 versus 95.3 ± 13.8 cm) and internal abdominal diameter (218.7 ± 33.0 vs 194.6 ± 25.7 mm) (both p < 0.001) were increased in patients with multi-vessel plaque whereas subcutaneous fat was unrelated to coronary plaque. Presence of fatty liver (93/318 patients, 29.2%) did not correlate with presence or extent of coronary plaque. The correlation of VAT with multi-vessel plaque although nominally independent of the metabolic syndrome (p = 0.04) was not independent of waist circumference. Conclusion: In asymptomatic subjects with DM and no history of CAD area of VAT correlated with the presence and extent of coronary atheroma but as a risk predictor added little independent information to that obtained by more readily obtainable measures of adiposity - waist circumference and internal abdominal diameter.

Original languageEnglish
Pages (from-to)184-188
Number of pages5
JournalInternational Journal of Cardiology
Issue number3
StatePublished - 20 Jan 2013
Externally publishedYes


  • Computed tomography
  • Coronary atheroma
  • Coronary calcium
  • Diabetes mellitus
  • Visceral fat

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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