Bos Daniel, Shahzad Rahil, van Walsum Theo, van Vliet Lucas J, Franco Oscar H, Hofman Albert, Niessen Wiro J, Vernooij Meike W, van der Lugt Aad
Department of Radiology, Erasmus MC, PO Box 2040, Rotterdam 3000CA, The Netherlands Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands.
Division of Image Processing, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.
Eur Heart J Cardiovasc Imaging. 2015 Nov;16(11):1264-9. doi: 10.1093/ehjci/jev086. Epub 2015 Apr 23.
To investigate relationships between epicardial fat volume and atherosclerosis in multiple major vessel beds.
From the population-based Rotterdam Study, 2298 participants underwent computed tomography examinations to quantify epicardial fat volume and atherosclerotic calcification volume in the coronary arteries, aortic arch, and extracranial and intracranial internal carotid arteries. Using linear regression modelling, we investigated relationships of epicardial fat volume with atherosclerotic calcification volume in each vessel bed, adjusting for conventional cardiovascular risk factors (waist circumference, systolic and diastolic blood pressure, total and high-density lipoprotein cholesterol, smoking, diabetes, and usage of blood pressure-lowering and lipid-lowering medication). To test whether associations of epicardial fat with calcification per vessel bed were independent of calcification elsewhere, we created a model in which all vessel beds were entered together. We found that a larger epicardial fat volume was associated with larger calcification volumes in the coronary arteries, aortic arch, and extracranial carotid arteries in both sexes. After adjustment for cardiovascular risk factors, larger epicardial fat volume was related to coronary and extracranial carotid artery calcification volume in males only [difference in calcification volume per SD increase in epicardial fat volume: 0.12 (95% confidence interval, CI: 0.04; 0.19) and 0.14 (95% CI: 0.06; 0.22)]. These associations remained unchanged after entering all vessel beds into one model.
Larger volumes of epicardial fat are associated with larger amounts of coronary and extracranial carotid artery atherosclerosis in males, independent of cardiovascular risk factors. This could imply that epicardial fat also exerts a systemic effect on atherosclerosis development. Future longitudinal research is warranted to further disentangle these relationships with a specific focus on sex differences.
研究心外膜脂肪体积与多个主要血管床动脉粥样硬化之间的关系。
在基于人群的鹿特丹研究中，2298名参与者接受了计算机断层扫描检查，以量化冠状动脉、主动脉弓以及颅外和颅内颈内动脉的心外膜脂肪体积和动脉粥样硬化钙化体积。我们使用线性回归模型，研究了每个血管床中心外膜脂肪体积与动脉粥样硬化钙化体积之间的关系，并对传统心血管危险因素（腰围、收缩压和舒张压、总胆固醇和高密度脂蛋白胆固醇、吸烟、糖尿病以及降压和降脂药物的使用情况）进行了校正。为了检验每个血管床中心外膜脂肪与钙化之间的关联是否独立于其他部位的钙化，我们构建了一个将所有血管床纳入的模型。我们发现，无论男女，心外膜脂肪体积越大，冠状动脉、主动脉弓和颅外颈动脉的钙化体积就越大。在对心血管危险因素进行校正后，仅在男性中，较大的心外膜脂肪体积与冠状动脉和颅外颈动脉钙化体积相关[心外膜脂肪体积每增加一个标准差，钙化体积差异：0.12（95%置信区间，CI：0.04；0.19）和0.14（95%CI：0.06；0.22）]。将所有血管床纳入一个模型后，这些关联保持不变。
在男性中，较大的心外膜脂肪体积与较多的冠状动脉和颅外颈动脉粥样硬化相关，且独立于心血管危险因素。这可能意味着心外膜脂肪对动脉粥样硬化的发展也有全身性影响。未来有必要进行纵向研究，以进一步厘清这些关系，尤其关注性别差异。
