Division of Cardiology, Korea University College of Medicine, Anam Hospital, Inchonro 73, Seongbukgu, Seoul, 136-705, Republic of Korea.
Cardiovasc Diabetol. 2018 Jun 30;17(1):95. doi: 10.1186/s12933-018-0735-7.
As body fat composition and metabolism differ between men and women, we evaluated sex-related differences in the association among epicardial adipose tissue (EAT), secretome profile, and myocardial function of subjects with suspected metabolic syndrome.
We evaluated 277 participants (men, n = 140; 56.1 ± 4.7 years) who underwent conventional echocardiography and two-dimensional speckle tracking from the Seoul Metabolic Syndrome cohort. EAT was measured from the right ventricular free wall perpendicular to the aortic annulus at end systole. Global longitudinal strain (GLS) was obtained from 18 apical segments. Apolipoprotein A1, apolipoprotein B, adiponectin, and high-sensitivity C-reactive protein (hs-CRP) levels were measured using immunoturbidimetry assay.
Mean age, body mass index, and hs-CRP level did not differ by sex. Waist circumference, fasting blood glucose level, and triglyceride/high-density lipoprotein cholesterol ratio were higher, and apolipoprotein AI and adiponectin levels were lower in men. No significant difference in mean EAT thickness was found (7.02 ± 1.81 vs. 7.13 ± 1.70 mm, p = 0.613). Men had a higher left ventricular (LV) mass index and lower GLS. EAT thickness was associated with hs-CRP level in men alone (ß = 0.206, p = 0.015). LV mass index (ß = 2.311, p = 0.037) and function represented by e' (ß = - 0.279, p = 0.001) and GLS (ß = - 0.332, p < 0.001) were independently associated with EAT thickness in men alone.
In middle-aged subjects with suspected metabolic syndrome, EAT was associated with inflammation represented by hs-CRP level, LV mass, and subclinical myocardial dysfunction only in men, suggesting that the inflammatory activity of EAT induced myocardial remodeling and dysfunction in middle-aged subjects but was attenuated in women. Trial registration NCT02077530 (date of registration: November 1, 2013).
由于男性和女性的体脂成分和代谢不同，我们评估了疑似代谢综合征患者的心外膜脂肪组织（EAT）、分泌组谱和心肌功能之间的关联中的性别差异。
我们评估了 277 名参与者（男性，n=140；56.1±4.7 岁），他们接受了来自首尔代谢综合征队列的常规超声心动图和二维斑点追踪检查。EAT 是从右心室游离壁在收缩末期垂直于主动脉瓣环处测量的。从 18 个心尖节段获得整体纵向应变（GLS）。使用免疫比浊法测定载脂蛋白 A1、载脂蛋白 B、脂联素和高敏 C 反应蛋白（hs-CRP）水平。
平均年龄、体重指数和 hs-CRP 水平在性别间无差异。腰围、空腹血糖水平和甘油三酯/高密度脂蛋白胆固醇比值较高，而载脂蛋白 AI 和脂联素水平较低。平均 EAT 厚度无显著差异（7.02±1.81 与 7.13±1.70mm，p=0.613）。男性的左心室（LV）质量指数较高，GLS 较低。EAT 厚度仅与男性的 hs-CRP 水平相关（β=0.206，p=0.015）。LV 质量指数（β=2.311，p=0.037）和由 e'（β=-0.279，p=0.001）和 GLS（β=-0.332，p<0.001）代表的功能与 EAT 厚度独立相关仅在男性中。
在疑似代谢综合征的中年人群中，EAT 与 hs-CRP 水平、LV 质量和亚临床心肌功能相关，仅在男性中与炎症相关，提示 EAT 的炎症活性导致中年人群的心肌重塑和功能障碍，但在女性中减弱。试验注册 NCT02077530（注册日期：2013 年 11 月 1 日）。
