Ozturk Mujgan Tek, Ebinç Fatma Ayerden, Okyay Gülay Ulusal, Kutlugün Aysun Akbal
Department of Cardiology.
Department of Nephrology, Kecioren Teaching and Research Hospital.
Acta Cardiol Sin. 2017 Jan;33(1):74-80. doi: 10.6515/acs20160418a.
Measurement of epicardial adipose tissue (EAT) is suggested as a novel cardiometabolic risk factor. Microalbuminuria is a marker of endothelial dysfunction and is associated with an increased risk for cardiovascular disease in patients with systemic hypertension. The aim of this study was to investigate the relationship of echocardiographic epicardial adipose tissue (EAT) thickness and microalbuminuria in hypertensive patients.
75 essential hypertensive patients were included into the study. All subjects underwent transthoracic echocardiography to measure EAT thickness. Spot urine sample was collected for the assessment of microalbuminuria. Patients were divided into two groups according to their spot urine albumin to creatinine ratio (UACR); Group 1 included normoalbuminuria (0-30 μg/mg); and Group 2: included microalbuminuria (30-300 μg/mg). Thereafter, we evaluated patient characteristics including smoking status, blood pressure, body mass index (BMI), antihypertensive treatment, statin therapy and serum levels of total cholesterol, low-density lipoprotein cholesterol, triglicerides, albumin, C-reactive protein (CRP), creatinine and hemoglobin.
There was no difference in baseline characteristics between Group 1 and Group 2. Patients with microalbuminuria had significantly higher mean EAT thickness values compared to the normoalbuminuria group (7.1 ± 0.9 vs. 6.6 ± 0.9, p = 0.01). There were positive significant correlations between EAT and age (r = 0.267, p = 0.020), serum creatinine (r = 0.292, p = 0.01), UACR (r = 0.251, p = 0.03), left ventricular mass (r = 0.257, p = 0.03) and left ventricular mass index (r = 0.242, p = 0.04). UACR was independently associated with EAT (p = 0.01) after adjustments were made for age and BMI.
Epicardial Adipose Tissue (EAT) thickness could be associated with microalbuminuria in patients with essential hypertension. This association could support the recognition of EAT as a credible marker in cardiovascular risk stratification.
心外膜脂肪组织（EAT）的测量被认为是一种新的心脏代谢危险因素。微量白蛋白尿是内皮功能障碍的标志物，与系统性高血压患者心血管疾病风险增加相关。本研究的目的是调查高血压患者超声心动图测量的心外膜脂肪组织（EAT）厚度与微量白蛋白尿之间的关系。
75例原发性高血压患者纳入本研究。所有受试者均接受经胸超声心动图检查以测量EAT厚度。收集随机尿样以评估微量白蛋白尿。根据随机尿白蛋白与肌酐比值（UACR）将患者分为两组；第1组包括正常白蛋白尿（0 - 30μg/mg）；第2组包括微量白蛋白尿（30 - 300μg/mg）。此后，我们评估了患者的特征，包括吸烟状况、血压、体重指数（BMI）、降压治疗、他汀类药物治疗以及总胆固醇、低密度脂蛋白胆固醇、甘油三酯、白蛋白、C反应蛋白（CRP）、肌酐和血红蛋白的血清水平。
第1组和第2组之间的基线特征无差异。与正常白蛋白尿组相比，微量白蛋白尿患者的平均EAT厚度值显著更高（7.1±0.9 vs. 6.6±0.9，p = 0.01）。EAT与年龄（r = 0.267，p = 0.020）、血清肌酐（r = 0.292，p = 0.01）、UACR（r = 0.251，p = 0.03）、左心室质量（r = 0.257，p = 0.03）和左心室质量指数（r = 0.242，p = 0.04）之间存在显著正相关。在对年龄和BMI进行调整后，UACR与EAT独立相关（p = 0.01）。
原发性高血压患者的心外膜脂肪组织（EAT）厚度可能与微量白蛋白尿相关。这种关联可能支持将EAT视为心血管风险分层中一个可靠的标志物。
