心外膜脂肪反映动脉僵硬度：使用 256 层多排冠状动脉计算机断层扫描和心踝血管指数评估。
Epicardial fat reflects arterial stiffness: assessment using 256-slice multidetector coronary computed tomography and cardio-ankle vascular index.
机构信息
Department of Internal Medicine, Health System Gangnam Center, Seoul National University Hospital, Seoul, Korea.
出版信息
J Atheroscler Thromb. 2012;19(6):570-6. doi: 10.5551/jat.12484. Epub 2012 Apr 4.
AIM
The cardio-ankle vascular index (CAVI) reflects overall arterial stiffness from the aorta to the ankle, independent of blood pressure. We aimed to investigate the association of fat burden assessed by visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT) and epicardial adipose tissue (EAT) with CAVI in an asymptomatic population.
METHODS
A total of 260 asymptomatic Korean individuals who had CAVI, abdominal computed tomography (CT) and coronary CT were evaluated retrospectively. The VAT, SAT, EAT and SAT to VAT ratio (SVR) were measured and assessed for correlation with CAVI.
RESULTS
Different fat compartments showed different correlations with arterial stiffness as assessed by CAVI. The amount of fat measured by VAT (r= 0.129, p= 0.037), EAT (r=0.193, p= 0.002) and SVR (r=-0.168, p= 0.007) showed a significant correlation with CAVI, whereas the amount of total abdominal fat and SAT did not (p= 0.261 and p= 0.434 respectively). From step-wise multivariate regression analysis including age, pulse pressure, fasting blood sugar level, VAT, SVR and EAT, EAT (p= 0.036) and age (p<0.001) showed significant associations with CAVI. When quartiles of CAVI were assessed, EAT showed serial increment, whereas SVR showed a stepwise decrease from the first quartile to fourth quartile of CAVI (p=0.041).
CONCLUSION
VAT, EAT and SVR, which reflect metabolic risk, have shown significant correlations with arterial stiffness measured by CAVI. EAT showed an independent association with arterial stiffness after adjusting for covariables by multivariable correlation analysis. Among the different parameters reflecting fat burden, EAT showed the strongest correlation with CAVI.
目的
心血管踝臂指数（CAVI）反映了从主动脉到脚踝的整体动脉僵硬度，与血压无关。我们旨在研究在无症状人群中，内脏脂肪组织（VAT）、皮下脂肪组织（SAT）和心外膜脂肪组织（EAT）所评估的脂肪负担与 CAVI 的相关性。
方法
回顾性分析了 260 名无症状韩国个体的 CAVI、腹部计算机断层扫描（CT）和冠状动脉 CT 检查结果。测量了 VAT、SAT、EAT 和 SAT 与 VAT 比值（SVR），并评估了它们与 CAVI 的相关性。
结果
不同的脂肪隔室与 CAVI 评估的动脉僵硬度有不同的相关性。VAT（r=0.129，p=0.037）、EAT（r=0.193，p=0.002）和 SVR（r=-0.168，p=0.007）的脂肪量与 CAVI 呈显著相关，而总腹部脂肪和 SAT 的脂肪量则无显著相关性（p=0.261 和 p=0.434 分别）。从包括年龄、脉压、空腹血糖水平、VAT、SVR 和 EAT 的逐步多元回归分析中，EAT（p=0.036）和年龄（p<0.001）与 CAVI 呈显著相关。当评估 CAVI 的四分位数时，EAT 呈连续递增，而 SVR 则从 CAVI 的第一四分位数到第四四分位数呈阶梯式下降（p=0.041）。
结论
反映代谢风险的 VAT、EAT 和 SVR 与 CAVI 测量的动脉僵硬度有显著相关性。通过多元相关分析调整协变量后，EAT 与动脉僵硬度呈独立相关。在反映脂肪负担的不同参数中，EAT 与 CAVI 的相关性最强。
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