Association Of Epicardial Adipose Tissue With Novel Inflammation And Heart Failure Biomarkers In Type 2 Diabetes Patients: Effect Of Metabolic Control

Background: Type 2 diabetes (T2D patients) have a 74% increased risk of heart failure (HF) but traditional HF biomarkers lack sensitivity in early disease detection. Increased epicardial adipose tissue volume (EATv) is associated with cardiovascular risk in T2D, and novel biomarkers such as, Growth differentiation factor 15 (GDF15), Galectin-3, and soluble suppression of tumorigenicity 2 (sST2) are inflammatory bi-omarkers linked to HF. Methods: we investigated associations between EATv, and inflammation biomarkers, and the effect of metabolic control in 14 healthy controls (HC) and 36 newly diagnosed T2D patients before (PGC) and after 12-months of metabolic optimization (GGC). EATv indexed to body surface area (iEATv) was quantified by multidetector computed tomography, and biomarker levels measured by immuno-assays. Results: PGC patients had higher iEATv (59.53±21.67 vs. 36.84±16.57 cm³/m², p=0.0017) and elevated GDF15, Galectin-3, and sST2 (all p< 0.05) than HC. The met-abolic optimization reduced iEATv (p=0.0232) and sST2 (p=0.048), while GDF15 and Galectin-3 remained unchanged. Multivariable analysis confirmed independent as-sociations between iEATv, GDF15 (β = 0.27, p = 0.027) and sST2 (β = 0.29, p = 0.02). Conclusions: these results support the link between systemic inflammation, EAT ex-pansion, and cardiac dysfunction, and the role of adiposity in the early HF risk of T2D patients.