Patil Harshal R, Patil Nirav T, King Samantha I, O'Keefe Evan, Chhabra Rajiv, Ansari Shaya, Kennedy Kevin F, Dey Damini, O'Keefe James H, Helzberg John H, Thompson Randall C
Saint Luke's Mid America Heart Institute, 4330 Wornall Road Suite 2000, Kansas City, MO, 64111, USA.
J Nucl Cardiol. 2014 Oct;21(5):880-9. doi: 10.1007/s12350-014-9946-9. Epub 2014 Aug 16.
Visceral adipose tissue (VAT) is associated with cardiac events, but it is not clear which, if any of the various measures of VAT independently correlate with coronary artery disease (CAD).
We studied 400 patients undergoing computed tomography to determine coronary artery calcium (CAC) score. VAT was measured in the form of epicardial adipose tissue (EAT) volume and thickness, intrathoracic adipose tissue volume (ITAV), and hepatic steatosis.
Of the 400 subjects, the average CAC score was 112.2 ± 389.3. When each measure of VAT (EAT volume and thickness, ITAV, hepatic steatosis) was added to the traditional model (they were independently associated with greater risk of CAC score ≥100 AU as measured by IDI/NRI (P < .05). On univariable logistic regression analysis, each of the 4 measures of VAT showed association with greater risk of a CAC score of ≥100 AU (OR > 1).
Each measure of VAT is a strong correlate of CAC score ≥100 AU in asymptomatic subjects-these VAT assessments correlate more significantly than do traditional CAD risk factors. This incremental power in the predictive models is likely the result of measurement of a fundamental expression of the metabolic syndrome and consequent proatherogenic derangements.
内脏脂肪组织(VAT)与心脏事件相关,但尚不清楚VAT的各种测量指标中,是否有任何一个能独立与冠状动脉疾病(CAD)相关。
我们研究了400例接受计算机断层扫描以确定冠状动脉钙化(CAC)评分的患者。VAT通过心外膜脂肪组织(EAT)体积和厚度、胸腔内脂肪组织体积(ITAV)以及肝脂肪变性的形式进行测量。
在400名受试者中,平均CAC评分为112.2±389.3。当将VAT的每项测量指标(EAT体积和厚度、ITAV、肝脂肪变性)添加到传统模型中时(通过IDI/NRI测量,它们与CAC评分≥100 AU的更高风险独立相关(P <.05)。在单变量逻辑回归分析中,VAT的4项测量指标中的每一项都显示与CAC评分≥100 AU的更高风险相关(OR>1)。
在无症状受试者中,VAT的每项测量指标都与CAC评分≥100 AU密切相关——这些VAT评估指标的相关性比传统CAD危险因素更显著。预测模型中的这种额外能力可能是代谢综合征基本表现测量以及随之而来的促动脉粥样硬化紊乱的结果。