Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, South Carolina; Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, South Carolina; Institute of Clinical Radiology, University of Munich, Munich, Germany.
Am J Cardiol. 2014 Feb 1;113(3):422-8. doi: 10.1016/j.amjcard.2013.10.014. Epub 2013 Nov 7.
Disparities in the risk of coronary artery disease (CAD) between races may be influenced by differences in the thoracic adipose tissue. We compared computed tomography (CT)-derived volumes of epicardial adipose tissue (EAT), mediastinal adipose tissue (MAT), and pericoronary fat thickness (PFT) and correlations with CAD between black and white patients. This institutional review board-approved Health Insurance Portability and Accountability Act-compliant study included 372 age- and gender-matched black versus white patients (186 black, 54 ± 11 years, 50% men; 186 white, 54 ± 11 years, 50% men) who underwent CT for chest pain evaluation. EAT, MAT, and PFT were measured. The amount of coronary calcium was quantified as calcium score. CAD was defined as ≥50% coronary artery narrowing. EAT and MAT volumes were significantly lower in black than white patients (59 [twenty-fifth to seventy-fifth percentile 39 to 84] vs 97 [67 to 132] cm(3) and 44 [27 to 77] vs 87 [52 to 157] cm(3), for both p <0.001). Mean PFT in black patients was slightly lower than white patients (17.2 ± 3.2 vs 18.1 ± 3.4 mm, p <0.01). The relation between race and extent of adipose tissue remained significant after adjustment for cardiovascular risk factors. Significant correlations were observed between EAT and MAT volumes and calcium score in black and white patients (r = 0.19 to 0.26, p <0.01). For both races, the level of thoracic fat measurements was higher in present versus absent coronary calcification. A greater amount of thoracic fat was found with obstructive CAD only in white patients. In conclusion, CT-derived measurements of thoracic fat differ between symptomatic black and white patients, suggesting a differential relation between thoracic adipose tissue and CAD pathophysiology by race.
种族间冠心病 (CAD) 的风险差异可能受胸内脂肪组织差异的影响。我们比较了黑人和白人患者 CT 衍生的心外膜脂肪组织 (EAT)、纵隔脂肪组织 (MAT) 和冠状动脉周围脂肪厚度 (PFT) 体积与 CAD 的相关性。这项经机构审查委员会批准、符合健康保险流通与责任法案的研究纳入了 372 例年龄和性别匹配的黑人和白人患者（186 例黑人，54 ± 11 岁，50%为男性；186 例白人，54 ± 11 岁，50%为男性），他们因胸痛行 CT 检查。测量了 EAT、MAT 和 PFT。冠状动脉钙的量用钙评分表示。CAD 定义为≥50%的冠状动脉狭窄。与白人患者相比，黑人患者的 EAT 和 MAT 体积明显较小（59 [25 至 75 百分位数 39 至 84] 比 97 [67 至 132] cm3 和 44 [27 至 77] 比 87 [52 至 157] cm3，均 p <0.001）。黑人患者的平均 PFT 略低于白人患者（17.2 ± 3.2 比 18.1 ± 3.4 mm，p <0.01）。调整心血管危险因素后，种族与脂肪组织程度之间的关系仍然显著。黑人和白人患者的 EAT 和 MAT 体积与钙评分之间存在显著相关性（r = 0.19 至 0.26，p <0.01）。对于两种种族，有或无冠状动脉钙化时，胸内脂肪测量值水平均较高。只有在白人患者中，阻塞性 CAD 与更多的胸内脂肪相关。总之，有症状的黑人和白人患者的 CT 衍生胸内脂肪测量值不同，这表明胸内脂肪组织与 CAD 病理生理学之间的种族差异存在不同关系。
