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Original article Long-term Association of Pericardial Adipose Tissue with Incident Diabetes and Prediabetes: the Coronary Artery Risk Development in Young Adults Study
Minsuk Oh1orcid , Wonhee Cho2orcid , Dong Hoon Lee3,4orcid , Kara M. Whitaker5orcid , Pamela J. Schreiner6orcid , James G. Terry7orcid , Joon Young Kim2orcid
Epidemiol Health 2022;e2023001
DOI: https://doi.org/10.4178/epih.e2023001 [Accepted]
Published online: December 3, 2022
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1Department of Public Health, Baylor University, Waco, TX, USA
2Department of Exercise Science, Syracuse University, Syracuse, NY, USA
3Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
4Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
5Department of Health and Human Physiology, Department of Epidemiology, University of Iowa, Iowa City, IA, USA
6Division of Epidemiology and Community Health, University of Minnesota, Twin Cities, MN, USA
7Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN
Corresponding author:  Joon Young Kim,
Email: jkim291@syr.edu
Received: 30 September 2022   • Revised: 2 December 2022   • Accepted: 3 December 2022

OBJECTIVES
We examined if pericardial adipose tissue (PAT) is predictive of prediabetes and type 2 diabetes over time.
METHODS
A total of 2,570 adults without prediabetes/diabetes from the Coronary Artery Risk Development in Young Adults Study were followed up over 15 years. PAT volume was measured by computed-tomography scans and new onset of prediabetes/diabetes was examined 5, 10, and 15 years after the PAT measurement. Multivariable Cox regression models were used to examine the association between tertile of PAT and up to 15 years later incident prediabetes/diabetes. The predictive ability of PAT (vs. waist circumference (WC), body mass index (BMI), waist-to-height ratio (WHtR)) for prediabetes/diabetes was examined by comparing the receiver operating characteristics curve (ROC)-area under the curve (AUC).
RESULTS
The highest tertile of PAT was associated with 1.56 (95% CI 1.03, 2.34) times higher rate of diabetes than the lowest tertile; however, no association was found between the highest tertile of PAT and prediabetes in the fully adjusted models, including additional adjustment for BMI or WC. In the fully adjusted models, the ROC-AUC of WC, BMI, WHtR, and PAT in predicting diabetes were not significantly different, whereas the ROC-AUC of WC in predicting prediabetes were higher than that of PAT.
CONCLUSIONS
PAT may be a significant predictor of hyperglycemia, but this association may be dependent on the effect of BMI or WC. Additional work is warranted to examine if novel adiposity indicators can suggest advanced and optimal information to the established diagnosis for prediabetes/diabetes.


Epidemiol Health : Epidemiology and Health