Schlett C L, Hoffmann U
Department of Radiology, Cardiac MR PET CT Program, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
Radiologe. 2011 May;51(5):372-8. doi: 10.1007/s00117-010-2088-4.
In addition to being overweight, as defined by the BMI, the distribution, composition and biological activity of adipose tissue are key elements in the cardiovascular risk stratification of patients. Several non-invasive techniques have been developed to quantify local fat depots, whereby computed tomography (CT) and magnetic resonance imaging (MRI) are the most important. In general adipose tissue is subdivided into subcutaneous and visceral compartments and although both are associated with cardiovascular risk factors and disease, visceral fat has on average a stronger association and a clearly higher biological activity independent of traditional risk factors. This maybe explained by the higher endocrine activity and secretion of pro-inflammatory cytokines by visceral fat. Especially pericardial adipose tissue, a local visceral fat depot surrounding the coronary arteries, is associated with the presence, extent and severity of coronary artery disease. However, several other local fat depots have been identified and associations with various diseases have been established. This article gives an overview over the current methods for the identification and quantification of local fat depots and summarizes the hypothesized and known associations. Furthermore, it gives an overview of the potential significance of individual local fat depots for cardiovascular risk stratification.
除了体重指数（BMI）所定义的超重外，脂肪组织的分布、组成和生物活性是患者心血管风险分层的关键因素。已经开发了几种非侵入性技术来量化局部脂肪堆积，其中计算机断层扫描（CT）和磁共振成像（MRI）最为重要。一般来说，脂肪组织可细分为皮下和内脏部分，尽管两者都与心血管危险因素和疾病有关，但内脏脂肪平均具有更强的关联性，并且在独立于传统危险因素的情况下具有明显更高的生物活性。这可能是由于内脏脂肪具有更高的内分泌活性和促炎细胞因子分泌。特别是心包脂肪组织，即围绕冠状动脉的局部内脏脂肪堆积，与冠状动脉疾病的存在、范围和严重程度相关。然而，已经确定了其他几种局部脂肪堆积，并建立了它们与各种疾病的关联。本文概述了目前识别和量化局部脂肪堆积的方法，并总结了假设的和已知的关联。此外，还概述了各个局部脂肪堆积对心血管风险分层的潜在意义。
