Targeting Epicardial Fat in Obesity and Diabetes Pharmacotherapy

Handb Exp Pharmacol. 2022:274:93-108. doi: 10.1007/164_2021_577.

Abstract

Epicardial adipose tissue surrounds and infiltrates the heart. Epicardial fat displays unique anatomic, genetic, and biomolecular properties. People with obesity and in particular, those with abdominal obesity and associated type 2 diabetes mellitus, have an increased amount of epicardial adipose tissue (EAT). Epicardial fat works well as therapeutic target due to its fast-responding metabolism, organ fat specificity, and easy measurability. Epicardial fat responds to thiazolidinediones (TZD), glucagon-like peptide 1-receptor agonists (GLP1A), sodium-glucose cotransporter 2 inhibitors (SGLT2i), dipeptidyl peptidase-4 inhibitors (DPP4i), and statins. Modulating epicardial fat morphology and genetic profile with targeted pharmacological agents suggests novel strategies in the pharmacotherapy of diabetes and obesity.

Keywords: Dipeptidyl peptidase-4 inhibitors; Epicardial adipose tissue: pharmaceutical target; Epicardial fat; Glucagon-like peptide 1-receptor agonists; Sodium glucose co-transporter 2 inhibitors; Statins; Thiazolidinediones.

MeSH terms

  • Adipose Tissue
  • Diabetes Mellitus, Type 2* / drug therapy
  • Dipeptidyl-Peptidase IV Inhibitors* / pharmacology
  • Dipeptidyl-Peptidase IV Inhibitors* / therapeutic use
  • Humans
  • Hypoglycemic Agents / pharmacology
  • Hypoglycemic Agents / therapeutic use
  • Obesity / drug therapy

Substances

  • Dipeptidyl-Peptidase IV Inhibitors
  • Hypoglycemic Agents