The relationship between metabolic diseases such as T2DM and regional fat deposits, particularly epicardial adipose tissue (EAT) and pericardial adipose tissue (PAT), play an important role in the development of cardiovascular diseases (CVD). Both EAT and PAT are a subset of visceral adipose tissue (VAT) associated with T2DM. They are metabolically active visceral fat deposits found around the heart, that are strongly associated with CVD including coronary artery disease (CAD) and the development of cardiac arrhythmias, predominantly due to the secretion of proinflammatory mediators and cytokines. In this paper, we review the emerging evidence of impact of T2DM on VAT and the specific role of EAT and PAT both as a cardiac risk marker and as a potentially active player in the development of cardiovascular pathology.
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