Department of Internal Medicine, Laboratory of Investigation on Metabolism and Diabetes LIMED, School of Medicine, State University of Campinas, Campinas, Brazil.
Metabolism. 2013 Jul;62(7):1032-6. doi: 10.1016/j.metabol.2013.01.022. Epub 2013 Mar 28.
Accumulation of epicardial (EAT) adipose tissue is associated with the development of an unfavorable metabolic risk profile. Gold standard methods used to assess this fat depot are not routinely applicable in the clinic. Anthropometric measures, including the sagittal abdominal diameter (SAD), have emerged as surrogate markers of visceral obesity. We determined the relationship between EAT measurement and cardiometabolic risk parameters and the potential use of the SAD, compared with other anthropometric parameters, as a practical estimation of EAT.
MATERIALS/METHODS: Sixty-seven premenopausal women were evaluated. The anthropometric parameters that were measured included waist circumference, SAD, body mass index and waist-to-hip ratio. EAT was determined by echocardiogram. Visceral adipose tissue (VAT) was determined by abdominal ultrasound. Insulin sensitivity was assessed by the hyperglycemic clamp.
The accumulation of EAT was correlated with impaired insulin sensitivity and decreased adiponectin. All of the anthropometric measurements were correlated with EAT. Interestingly, EAT was most significantly correlated with the SAD. From the ROC analysis, we found that the SAD measurements were very accurate, presenting the highest area under the curve for EAT (0.81; p<0.01) when compared with the other measurements. In the multiple linear regression analysis, EAT was moderately predicted by the SAD (R²=0.25; p<0.001).
SAD, a simple anthropometric measure, accurately estimated EAT and thus represents a clinically useful non-invasive marker that can identify patients with EAT accumulation.
心外膜(EAT)脂肪组织的积累与不利代谢风险特征的发展有关。评估这种脂肪库的金标准方法在临床上并不常用。人体测量学指标,包括矢状腹部直径(SAD),已成为内脏肥胖的替代标志物。我们确定了 EAT 测量与心血管代谢风险参数之间的关系,并确定了 SAD 与其他人体测量参数相比作为 EAT 实用估计值的潜在用途。
材料/方法:评估了 67 名绝经前妇女。测量的人体测量参数包括腰围、SAD、体重指数和腰臀比。EAT 通过超声心动图确定。内脏脂肪组织(VAT)通过腹部超声确定。胰岛素敏感性通过高血糖钳夹评估。
EAT 的积累与胰岛素敏感性受损和脂联素降低有关。所有的人体测量值都与 EAT 相关。有趣的是,EAT 与 SAD 最显著相关。从 ROC 分析中,我们发现 SAD 测量值非常准确,当与其他测量值相比时,SAD 测量值对 EAT 的曲线下面积最高(0.81;p<0.01)。在多元线性回归分析中,SAD 可适度预测 EAT(R²=0.25;p<0.001)。
SAD 是一种简单的人体测量学指标,可准确估计 EAT,因此代表了一种有用的临床非侵入性标志物,可以识别 EAT 积累的患者。