Department of Vascular Medicine, University Medical Center Utrecht, The Netherlands.
Atherosclerosis. 2011 Jan;214(1):3-10. doi: 10.1016/j.atherosclerosis.2010.05.034. Epub 2010 Jun 1.
Perivascular adipose tissue surrounds (coronary) arteries and may be involved in local stimulation of atherosclerotic plaque formation. Epicardial adipose tissue, the adipose tissue within the pericardium, is a frequently used measure of coronary perivascular adipose tissue and can be quantified with echocardiography, computed tomography (CT) and magnetic resonance imaging (MRI). The quantity of (coronary) perivascular adipose tissue is correlated with parameters of the metabolic syndrome, such as increased waist circumference, hypertriglyceridemia and hyperglycemia, and with coronary atherosclerosis. Coronary artery segments covered by myocardium are not exposed to coronary perivascular adipose tissue and interestingly, atherosclerosis is absent in these intra-myocardial segments. Pro-inflammatory cytokines and adipokines are expressed and secreted at a higher level in epicardial adipose tissue of patients with coronary artery disease compared to patients without coronary artery disease. Furthermore, in vitro and ex vivo perivascular adipose tissue induces inflammation of the artery wall by secretion of pro-inflammatory proteins. Atherogenesis in the vascular wall is thus stimulated from 'outside to inside'. Based on the results of clinical, ex vivo and in vitro studies, it can be argued that perivascular adipose tissue may be involved in the process of atherosclerosis.
血管周围脂肪组织环绕（冠状动脉），并可能参与局部刺激动脉粥样硬化斑块形成。心外膜脂肪组织是心包内的脂肪组织，是冠状动脉血管周围脂肪组织的常用测量指标，可通过超声心动图、计算机断层扫描（CT）和磁共振成像（MRI）进行定量。（冠状动脉）血管周围脂肪组织的数量与代谢综合征的参数相关，如腰围增加、高三酰甘油血症和高血糖症，以及与冠状动脉粥样硬化相关。心肌覆盖的冠状动脉节段不暴露于冠状动脉血管周围脂肪组织，有趣的是，这些心肌内节段没有动脉粥样硬化。与无冠状动脉疾病的患者相比，患有冠状动脉疾病的患者的心外膜脂肪组织中表达和分泌的促炎细胞因子和脂肪因子水平更高。此外，体外和离体血管周围脂肪组织通过分泌促炎蛋白引起动脉壁炎症。因此，血管壁中的动脉粥样硬化形成是从“外向内”刺激的。基于临床、离体和体外研究的结果，可以认为血管周围脂肪组织可能参与动脉粥样硬化的过程。
