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心包脂肪、胸腔内脂肪和腹内脂肪与心血管疾病负担的关联:弗雷明汉心脏研究

Association of pericardial fat, intrathoracic fat, and visceral abdominal fat with cardiovascular disease burden: the Framingham Heart Study.

作者信息

Mahabadi Amir A, Massaro Joseph M, Rosito Guido A, Levy Daniel, Murabito Joanne M, Wolf Philip A, O'Donnell Christopher J, Fox Caroline S, Hoffmann Udo

机构信息

Cardiac MR PET CT Program, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 165 Charles River Plaza, Boston, MA 02114, USA.

出版信息

Eur Heart J. 2009 Apr;30(7):850-6. doi: 10.1093/eurheartj/ehn573. Epub 2009 Jan 9.

Abstract

AIMS

The aim of this study was to assess whether pericardial fat, intrathoracic fat, and visceral abdominal adipose tissue (VAT) are associated with the prevalence of cardiovascular disease (CVD).

METHODS AND RESULTS

Participants from the Framingham Heart Study Offspring cohort underwent abdominal and chest multidetector computed tomography to quantify volumes of pericardial fat, intrathoracic fat, and VAT. Relations between each fat depot and CVD were assessed using logistic regression. The analysis of 1267 participants (mean age 60 years, 53.8% women, 9.7% with prevalent CVD) demonstrated that pericardial fat [odds ratio (OR) 1.32, 95% confidence interval (CI) 1.11-1.57; P = 0.002] and VAT (OR 1.35, 95% CI 1.11-1.57; P = 0.003), but not intrathoracic fat (OR 1.14, 95% CI 0.93-1.39; P = 0.22), were significantly associated with prevalent CVD in age-sex-adjusted models and after adjustment for body mass index and waist circumference. After multivariable adjustment, associations were attenuated (P > 0.14). Only pericardial fat was associated with prevalent myocardial infarction after adjusting for conventional measures of adiposity (OR 1.37, 95% CI 1.03-1.82; P = 0.03).

CONCLUSION

Pericardial fat and VAT, but not intrathoracic fat, are associated with CVD independent of traditional measures of obesity but not after further adjustment for traditional risk factor. Taken together with our prior work, these findings may support the hypothesis that pericardial fat contributes to coronary atherosclerosis.

摘要

目的

本研究旨在评估心包脂肪、胸腔内脂肪和腹部内脏脂肪组织(VAT)是否与心血管疾病(CVD)的患病率相关。

方法与结果

弗雷明汉心脏研究后代队列的参与者接受了腹部和胸部多层螺旋计算机断层扫描,以量化心包脂肪、胸腔内脂肪和VAT的体积。使用逻辑回归评估每个脂肪库与CVD之间的关系。对1267名参与者(平均年龄60岁,53.8%为女性,9.7%患有CVD)的分析表明,在年龄和性别调整模型以及调整体重指数和腰围后,心包脂肪[比值比(OR)1.32,95%置信区间(CI)1.11 - 1.57;P = 0.002]和VAT(OR 1.35,95% CI 1.11 - 1.57;P = 0.003)与CVD患病率显著相关,但胸腔内脂肪不相关(OR 1.14,95% CI 0.93 - 1.39;P = 0.22)。经过多变量调整后,相关性减弱(P > 0.14)。在调整肥胖的传统测量指标后,只有心包脂肪与心肌梗死患病率相关(OR 1.37,95% CI 1.03 - 1.82;P = 0.03)。

结论

心包脂肪和VAT与CVD相关,独立于传统肥胖测量指标,但在进一步调整传统危险因素后则不相关。结合我们之前的研究工作,这些发现可能支持心包脂肪促成冠状动脉粥样硬化的假说。

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