3-OR: Lipoprotein(a) Levels and Epicardial Adipose Tissue in Diabetes—Unraveling Novel Connections

Introduction & Objectives: While extremely high levels of lipoprotein (a) [Lp(a)] are associated with an increased risk of cardiovascular disease, very low levels of Lp(a) have been associated with an increased risk of diabetes. The underlying mechanisms explaining this association are still unknown. Epicardial adipose tissue (EAT) is increased in diabetes and predicts the development of coronary artery disease and heart failure. This study aimed at evaluating the correlation between Lp(a) and EAT in subjects living with diabetes. Methods: We collected clinical data from 1,093 subjects living with diabetes in a monocentric retrospective observational study. Patients were included if they were in primary prevention, had had a measurement of Lp(a) and computed tomography (CT) for coronary artery calcium score quantification. Volumetric quantification of EAT was performed on CT images. Results: We included 649 people living with diabetes (76.3% T2DM, 16.5% T1DM, 7.2% others) for 13.5±9.6 years, body mass index (BMI) 29.3±6.0 kg/m², HbA1c 8.9±2.3%, EAT volume 91±41 cm3. EAT volume and Lp(a) levels were correlated (r=-0.2, p30 mg/dl (n=227, 35%), were more frequent in women and people from sub-Saharan Africa, and associated with higher HDL (p