Department of Cardiology, Ajou University School of Medicine, Suwon, Korea.
Cardiovasc Diabetol. 2010 Jul 7;9:29. doi: 10.1186/1475-2840-9-29.
In a previous study, we demonstrated that the thickness of epicardial adipose tissue (EAT), measured by echocardiography, was increased in patients with metabolic syndrome (MS) and coronary artery disease (CAD). Several studies on obese patients, however, failed to demonstrate any relationship between EAT and CAD. We hypothesized that body mass index (BMI) affected the link between EAT and MS and CAD.
We consecutively enrolled 643 patients (302 males, 341 females; 59 +/- 11 years), who underwent echocardiography and coronary angiography. The EAT thickness was measured on the free wall of the right ventricle at the end of diastole. All patients were divided into two groups: high BMI group, > or = 27 kg/m2 (n = 165), and non-high BMI group, < 27 kg/m2 (n = 478).
The median and mean EAT thickness of 643 patients were 3.0 mm and 3.1 +/- 2.4 mm, respectively. In the non-high BMI group, the median EAT thickness was significantly increased in patients with MS compared to those without MS (3.5 vs. 1.9 mm, p < 0.001). In the high BMI group, however, there was no significant difference in the median EAT thickness between patients with and without MS (3.0 vs. 2.5 mm, p = 0.813). A receiver operating characteristic (ROC) curve analysis predicting MS revealed that the area under the curve (AUC) of the non-high BMI group was significantly larger than that of the high BMI group (0.659 vs. 0.506, p = 0.007). When compared to patients without CAD, patients with CAD in both the non-high and high BMI groups had a significantly higher median EAT thickness (3.5 vs. 1.5 mm, p < 0.001 and 4.0 vs. 2.5 mm, p = 0.001, respectively). However, an ROC curve analysis predicting CAD revealed that the AUC of the non-high BMI group tended to be larger than that of the high BMI group (0.735 vs. 0.657, p = 0.055).
While EAT thickness was significantly increased in patients with MS and CAD, the power of EAT thickness to predict MS and CAD was stronger in patients with BMI < 27 kg/m2. These findings showed that the measurement of EAT thickness by echocardiography might be especially useful in an Asian population with a non-high BMI, less than 27 kg/m2.
在之前的研究中，我们证明了通过超声心动图测量的心外膜脂肪组织（EAT）厚度在代谢综合征（MS）和冠状动脉疾病（CAD）患者中增加。然而，几项关于肥胖患者的研究未能证明 EAT 与 CAD 之间存在任何关系。我们假设体重指数（BMI）影响 EAT 与 MS 和 CAD 之间的联系。
我们连续纳入 643 名患者（男性 302 名，女性 341 名；59 ± 11 岁），他们接受了超声心动图和冠状动脉造影检查。在舒张末期测量右心室游离壁上的 EAT 厚度。所有患者分为两组：高 BMI 组，≥ 27kg/m2（n = 165）和非高 BMI 组，< 27kg/m2（n = 478）。
643 名患者的中位数和平均值 EAT 厚度分别为 3.0mm 和 3.1 ± 2.4mm。在非高 BMI 组中，与无 MS 患者相比，MS 患者的 EAT 厚度中位数显著增加（3.5 与 1.9mm，p < 0.001）。然而，在高 BMI 组中，MS 患者与无 MS 患者的 EAT 厚度中位数无显著差异（3.0 与 2.5mm，p = 0.813）。预测 MS 的受试者工作特征（ROC）曲线分析显示，非高 BMI 组的曲线下面积（AUC）显著大于高 BMI 组（0.659 与 0.506，p = 0.007）。与无 CAD 患者相比，非高 BMI 组和高 BMI 组中 CAD 患者的 EAT 厚度中位数均显著升高（3.5 与 1.5mm，p < 0.001 和 4.0 与 2.5mm，p = 0.001）。然而，预测 CAD 的 ROC 曲线分析显示，非高 BMI 组的 AUC 倾向于大于高 BMI 组（0.735 与 0.657，p = 0.055）。
尽管 EAT 厚度在 MS 和 CAD 患者中显著增加，但在 BMI<27kg/m2 的患者中，EAT 厚度预测 MS 和 CAD 的能力更强。这些发现表明，通过超声心动图测量 EAT 厚度在 BMI<27kg/m2 的亚洲人群中可能特别有用。
Zotero 插件
