CORRELATION OF EPICARDIAL FAT THICKNESS AND CAROTID INTIMA-MEDIA THICKNESS (CIMT) WITH GLYCEMIC CONTROL IN PATIENTS WITH TYPE 2 DIABETES MELLITUS.
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Keywords
Type 2 Diabetes Mellitus, Epicardial Fat Thickness, Carotid Intima-Media Thickness, HbA1c, Subclinical Atherosclerosis.
Abstract
Background: Type 2 Diabetes Mellitus (T2DM) is a major driver of premature atherosclerosis and cardiovascular morbidity in the South Indian population. While Glycated Hemoglobin (HbA1c) is the standard for monitoring glycemic control, its direct relationship with structural markers of subclinical atherosclerosis remains a subject of intense clinical interest. This study evaluates the correlation of two non-invasive ultrasonographic markers—Epicardial Fat Thickness (EFT) and Carotid Intima-Media Thickness (CIMT)—with long-term glycemic control in T2DM patients.
Methods: A hospital-based cross-sectional study was conducted at the Kamineni Institute of Medical Sciences (2015–2016) involving 150 patients with T2DM. Participants were stratified into two groups based on their glycemic control: Good Control (HbA1c < 7%) and Poor Control (HbA1c ≥ 7%). EFT was measured via transthoracic echocardiography (parasternal long-axis view), and CIMT was assessed using B-mode ultrasonography of the common carotid arteries.
Results: Patients with poor glycemic control (HbA1c ≥ 7%) exhibited significantly higher mean EFT (6.2 ± 1.1 mm vs. 4.8 ± 0.9 mm, p < 0.001) and CIMT (0.84 ± 0.12 mm vs. 0.68 ± 0.08 mm, p < 0.01) compared to the good control group. A strong positive correlation was observed between HbA1c levels and both EFT (r = 0.64, p < 0.001) and CIMT (r = 0.58, p < 0.001). Furthermore, a significant linear relationship was found between EFT and CIMT (r = 0.72), suggesting that visceral fat surrounding the heart serves as a proxy for systemic vascular thickening.
Conclusion: Elevated EFT and CIMT are closely associated with poor glycemic control in T2DM patients. These findings suggest that bedside ultrasonographic assessment of epicardial fat and carotid thickness can serve as reliable, non-invasive indicators of subclinical atherosclerosis and cardiovascular risk in the diabetic population of rural South India.
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Dr. Naineni Prakash Mahesh Kumar
Assistant Professor, Department Of General Medicine, Kamineni Institute Of Medical Science
