Long Benjamin D, Stojanovska Jadranka, Brown Richard K J, Attili Anil K, Jackson Eizabeth A, Ognenovski Vladimir
University of Michigan Medical School, Ann Arbor, Michigan.
Department of Radiology, Cardiothoracic Radiology Division, Frankel Cardiovascular Center, Room 5481, 1500 E. Medical Center Drive, Ann Arbor, MI.
Acad Radiol. 2017 Dec;24(12):1473-1481. doi: 10.1016/j.acra.2017.07.003. Epub 2017 Aug 26.
The study aimed to determine if intrathoracic fat volumes are associated with the presence and severity of systemic sclerosis (SSc), defined by the presence of pulmonary arterial hypertension (PAH).
A total of 265 patients were included in the study, 202 of whom had SSc (134 had SSc with no PAH and 68 had SSc-associated PAH) and who underwent high-resolution computed tomography, and 63 controls who underwent coronary computed tomography angiography with calcium scoring. Intrathoracic and epicardial (EFV) fat volumes were quantified by manual tracing of the mediastinum and the pericardium, the difference of which represents the extrapericardial fat volume. Associations between these three fat volumes and the presence and severity of SSc, adjusted for cardiovascular risk factors and interstitial lung disease, were evaluated by logistic regression analysis.
Of the 202 patients with SSc, the mean age was 55 years (ranged from 20 to 86), and 79% (159 of 202) were women. Adjusted EFV (odds ratio [OR]: 1.065; 95% confidence interval [CI]: 1.046-1.084, P = < 0.0001), extrapericardial fat volume (OR: 1.028, 95% CI: 1.017-1.038, P = < 0.0001), and intrathoracic fat volume (OR: 1.033, 95% CI: 1.023-1.043, P = 0.001) were associated with the presence of SSc. Only EFV was associated with SSc severity (adjusted OR: 1.010, 95% CI: 1.003-1.018, P = 0.007).
Increased epicardial fat volume is associated with the presence and severity of SSc, independent of cardiovascular risk factors and interstitial lung disease.
本研究旨在确定胸腔内脂肪体积是否与系统性硬化症（SSc）的存在及严重程度相关，SSc由肺动脉高压（PAH）的存在来定义。
共有265名患者纳入本研究，其中202名患有SSc（134名患有无PAH的SSc，68名患有与SSc相关的PAH）并接受了高分辨率计算机断层扫描，63名对照者接受了带有钙化评分的冠状动脉计算机断层血管造影。通过手动描绘纵隔和心包来量化胸腔内和心外膜（EFV）脂肪体积，两者之差代表心包外脂肪体积。通过逻辑回归分析评估这三种脂肪体积与SSc的存在及严重程度之间的关联，并对心血管危险因素和间质性肺病进行了校正。
在202名SSc患者中，平均年龄为55岁（范围为20至86岁），79%（202名中的159名）为女性。校正后的EFV（比值比[OR]：1.065；95%置信区间[CI]：1.046 - 1.084，P = < 0.0001）、心包外脂肪体积（OR：1.028，95% CI：1.017 - 1.038，P = < 0.0001）和胸腔内脂肪体积（OR：1.033，95% CI：1.023 - 1.043，P = 0.001）与SSc的存在相关。只有EFV与SSc严重程度相关（校正后的OR：1.010，95% CI：1.003 - 1.018，P = 0.007）。
心外膜脂肪体积增加与SSc的存在及严重程度相关，独立于心血管危险因素和间质性肺病。
