ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Clinical Diabetes
This article is part of the Research TopicInflammation and Diabetes: Unraveling Vascular Complications and Therapeutic InnovationsView all articles
Quantifying the Link: Coronary Artery Inflammation via CCTA-Derived Fat Attenuation Index and its Association with Diabetes Duration
Provisionally accepted
- 1Tianjin Medical University, Tianjin, China
- 2Tianjin Union Medical Center, Tianjin, China
- 3Department of Cardiology, Tianjin Medical University Chu Hsien-I Memorial Hospital, Tianjin, China
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Aims: Although diabetes is a well-established enhancer of coronary inflammation, the specific relationship between diabetes duration and the degree of inflammation, as quantified by pericoronary fat attenuation index (FAI), remains poorly defined. This study aimed to investigate the association between diabetes duration and coronary inflammation, as assessed non-invasively by the pericoronary FAI derived from coronary computed tomography angiography (CCTA). Materials and methods: We enrolled 468 adults with type 2 diabetes mellitus who underwent CCTA imaging. The pericoronary FAI was quantified around the three main coronary arteries. Multivariable linear regression and subgroup analyses were performed to evaluate the association between diabetes duration and pericoronary FAI. Potential non-linear associations were examined using restricted cubic spline (RCS) modelling. Results: Longer diabetes duration was independently and positively associated with increased pericoronary FAI values in the LAD artery (β = 0.151, 95% CI: 0.064–0.238, P = 0.001), LCX artery (β = 0.101, 95% CI: 0.001–0.201, P = 0.047), and RCA (β = 0.208, 95% CI: 0.120–0.296, P < 0.001). RCS modelling revealed predominantly linear associations(P for non-linearity > 0.05). The association between diabetes duration and pericoronary FAI remained robust across the majority of examined subgroups. Conclusion: Prolonged diabetes duration is independently associated with elevated coronary inflammation, demonstrating a near-linear dose-response relationship.
Keywords: cardiovascular disease, High fasting plasma glucose, pericoronary fat attenuation index, Coronary artery inflammation, Diabetes duration
Received: 23 Jul 2025; Accepted: 17 Nov 2025.
Copyright: © 2025 Zhang, Wang, Song and Yao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Zhuhua Yao, tjumccardio@126.com
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