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Meta-Analysis
. 2019 Jan 10;18(1):3.
doi: 10.1186/s12933-019-0807-3.

Epicardial fat tissue in patients with diabetes mellitus: a systematic review and meta-analysis

Yingrui Li  1 , Bin Liu  1 , Yu Li  1 , Xiaodong Jing  1 , Songbai Deng  1 , Yulin Yan  1 , Qiang She  2
Affiliations
Meta-Analysis

Epicardial fat tissue in patients with diabetes mellitus: a systematic review and meta-analysis

Yingrui Li et al. Cardiovasc Diabetol. .

Abstract

Background: Epicardial fat tissue (EFT) is the visceral fat distributed along the coronary arteries between the pericardium and the myocardium. Increases in EFT are closely related to the occurrence of diabetes mellitus (DM) and cardiovascular disease. To further understand the link between EFT and DM, we conducted a meta-analysis of the relevant literature.

Methods: We systematically searched electronic databases for studies on EFT performed in DM patients and published up to 30 September 2018. We included data on EFT in a DM patient group and a non-DM control group. We then assessed the effect of DM on EFT by meta-analysis and trial sequential analysis (TSA). All statistical analyses were performed using Stata 12.0 and TSA software.

Results: A total of 13 studies (n = 1102 patients) were included in the final analysis. Compared with the control group, DM patients had significantly higher EFT (SMD: 1.23; 95% CI 0.98, 1.48; P = 0.000; TSA-adjusted 95% CI 0.91, 2.13; P < 0.0001). The TSA indicated that the available samples were sufficient and confirmed that firm evidence was reached. According to the regression analysis and subgroup analyses, DM typing, EFT ultrasound measurements, total cholesterol (TC) and triglyceride (TG) levels were confounding factors that significantly affected our results.

Conclusions: Our meta-analysis suggests that the amount of EFT is significantly higher in DM patients than in non-DM patients.

Keywords: Diabetes mellitus; Epicardial fat tissue; Meta-analysis.

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Figures

Fig. 1
Fig. 1
Flowchart of the study selection process used to identify studies to be included in the meta-analysis
Fig. 2
Fig. 2
SMD in EFT between patients with DM and the non-DM control group. a Meta-analysis; b trial sequential analysis
Fig. 3
Fig. 3
Evaluation of publication bias by funnel plot and Begg’s test. a Visual evaluation of the funnel plot on enrolled DM patients and the non-DM control group; b Begg’s test to assess publication bias in the included studies
Fig. 4
Fig. 4
Subgroup analysis of SMD in EFT between patients with DM and the non-DM control group: a subgroup analysis by DM typing (T1DM or T2DM); b subgroup analyses by different measurements of EFT (CT or ultrasonic)
Fig. 5
Fig. 5
Meta-regression analyses of SMD in EFT between patients with DM and the non-DM control group: a effect of TC on EFT; b effect of TG on EFT
See this image and copyright information in PMC

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