颈总动脉内膜中层厚度与心包脂肪在动脉粥样硬化多民族研究（MESA）中的关系。
Association between carotid intima-media thickness and pericardial fat in the Multi-Ethnic Study of Atherosclerosis (MESA).
机构信息
Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston Salem, North Carolina 27104, USA.
出版信息
J Stroke Cerebrovasc Dis. 2010 Jan;19(1):58-65. doi: 10.1016/j.jstrokecerebrovasdis.2009.03.008.
INTRODUCTION
Carotid intima-media thickness (IMT) is a subclinical marker of atherosclerosis and a strong predictor of stroke. Pericardial fat (PF), the fat depot around the heart, has been associated with several atherosclerosis risk factors. We sought to examine the association between carotid IMT and PF, and to examine whether such an association is independent from common atherosclerosis risk factors including measures of overall adiposity.
METHODS
Unadjusted and multivariable-adjusted linear regression analysis was used to examine associations between common carotid artery (CCA) IMT and internal carotid artery (ICA) IMT with PF in a random sample of 996 participants from the Multi-Ethnic Study of Atherosclerosis (MESA) who underwent carotid ultrasound and chest computed tomography at baseline examination.
RESULTS
A significant positive correlation was observed between PF and CCA-IMT (r=0.27, P < .0001) and ICA-IMT (r=0.17, P < .0001). In an unadjusted sex-specific linear regression analysis, there was a significant association between PF (1-SD difference) and CCA-IMT (mm) in both women (beta coefficient [95% confidence interval]: 0.06 [0.04, 0.08], P < .0001) and men (0.03 [0.01, 0.05], P < .0002), an association that persisted after further adjusting for age and ethnicity (0.02 [+0.00, 0.04], P=.0120 for women, and 0.02 [+0.00, 0.03], P=.0208 for men). However, after additional adjustment for atherosclerosis risk factors and either body mass index or waist circumference, these relations were no longer significant in either sex. In similar analyses, PF was significantly associated with ICA-IMT in both men (0.11 [0.06, 0.15], P < .0001) and women (0.08 [0.02, 0.13], P=.0041). These relations were no longer significant in women in multivariable-adjusted models, but persisted in men in all models except after adjusting for age, ethnicity, and waist circumference.
CONCLUSIONS
In the general population PF is associated with carotid IMT, an association that possibly is not independent from markers of overall adiposity or common atherosclerosis risk factors.
简介
颈动脉内膜中层厚度（IMT）是动脉粥样硬化的亚临床标志物，也是中风的强有力预测因子。心包脂肪（PF）是心脏周围的脂肪沉积，与多种动脉粥样硬化危险因素有关。我们旨在研究颈动脉 IMT 与 PF 之间的关联，并研究这种关联是否独立于常见的动脉粥样硬化危险因素，包括整体肥胖的测量指标。
方法
在基线检查时，对来自动脉粥样硬化多民族研究（MESA）的 996 名参与者进行颈动脉超声和胸部计算机断层扫描，使用未调整和多变量调整的线性回归分析，研究颈总动脉（CCA）IMT 和颈内动脉（ICA）IMT 与 PF 之间的关系。
结果
PF 与 CCA-IMT（r=0.27，P<.0001）和 ICA-IMT（r=0.17，P<.0001）之间存在显著的正相关。在未调整的性别特异性线性回归分析中，PF（1-SD 差异）与 CCA-IMT（mm）在女性（β系数[95%置信区间]：0.06[0.04, 0.08]，P<.0001）和男性（0.03[0.01, 0.05]，P<.0002）之间存在显著关联，这种关联在进一步调整年龄和种族后仍然存在（女性 0.02[+0.00, 0.04]，P=.0120；男性 0.02[+0.00, 0.03]，P=.0208）。然而，在进一步调整动脉粥样硬化危险因素以及体重指数或腰围后，这些关系在两性中均不再显著。在类似的分析中，PF 与男性的 ICA-IMT 显著相关（0.11[0.06, 0.15]，P<.0001）和女性（0.08[0.02, 0.13]，P=.0041）。在多变量调整模型中，这些关系在女性中不再显著，但在除调整年龄、种族和腰围外的所有模型中仍在男性中存在。
结论
在一般人群中，PF 与颈动脉 IMT 相关，这种关联可能与整体肥胖标志物或常见动脉粥样硬化危险因素无关。
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