Prakaschandra Rosaley D, Naidoo Datshana P
Department of Biomedical and Clinical Technology, Durban University of Technology, Durban, South Africa.
Department of Cardiology, University of KwaZulu-Natal, KwaZulu-Natal, South Africa.
J Cardiovasc Echogr. 2018 Jul-Sep;28(3):160-165. doi: 10.4103/jcecho.jcecho_71_17.
We sought to determine the association of echocardiographically derived epicardial adipose tissue (EAT) thickness, which is a component of visceral adipose tissue, with the metabolic syndrome (MetS) in a cohort of randomly selected community participants.
South African-Asian Indians aged 15-64 years were recruited over a 2-year period after informed consent was obtained. All participants who had complete measurements done for biochemistry and echocardiography (using established criteria), were dichotomized into the MetS or non-MetS groups defined according to the harmonized criteria.
Of the 953 (232 men and 721 women) participants recruited, 47.1% (448) were classified with the MetS. These participants had larger waist circumference and body mass index ( < 0.001), with larger LA volumes and diameter, thicker ventricular walls, higher left ventricular mass, relative wall thickness, and EAT ( < 0.001). There was a corresponding increase in EAT thickness with increasing number of MetS risk factors at the transition from 0 MetS factors to 1 (95% confidence interval [CI] -0.8; -0.2) and from 2 to 3 MetS factors (95% CI -0.9; -0.4). The AUC of the receiver operator curve was highest for triglycerides (0.845), followed by fasting plasma glucose (0.795) and then EAT (0.789). An EAT value of <3.6 mm predicted the presence of the MetS with a 78% sensitivity and 70% specificity. Using backward stepwise logistic regression, the most significant independent determinants of the MetS after adjusting for age, gender, and type 2 diabetes mellitus, was fasting plasma glucose (odds ratio [OR] = 1.2), triglycerides (OR = 7.1), and EAT (OR = 2.3).
Although EAT is associated with the MetS, and can identify individuals at increased cardiometabolic risk, it has a limited additional role compared to current risk markers.
我们试图在一组随机选取的社区参与者中，确定作为内脏脂肪组织一部分的经超声心动图测量得出的 epicardial adipose tissue（EAT）厚度与代谢综合征（MetS）之间的关联。
在获得知情同意后，于两年内招募了年龄在 15 - 64 岁的南非亚裔印度人。所有完成生化和超声心动图完整测量（使用既定标准）的参与者，根据统一标准被分为 MetS 组或非 MetS 组。
在招募的 953 名参与者（232 名男性和 721 名女性）中，47.1%（448 名）被归类为患有 MetS。这些参与者的腰围和体重指数更大（<0.001），左心房容积和直径更大，心室壁更厚，左心室质量、相对壁厚和 EAT 更大（<0.001）。从 0 个 MetS 因素到 1 个（95%置信区间[CI] -0.8；-0.2）以及从 2 个到 3 个 MetS 因素转变时，随着 MetS 危险因素数量的增加，EAT 厚度相应增加。受试者工作特征曲线的曲线下面积（AUC）中甘油三酯最高（0.845），其次是空腹血糖（0.795），然后是 EAT（0.789）。EAT 值<3.6 mm 预测 MetS 的存在时，敏感性为 78%，特异性为 70%。在调整年龄、性别和 2 型糖尿病后，使用向后逐步逻辑回归分析，MetS 最显著的独立决定因素是空腹血糖（比值比[OR]=1.2）、甘油三酯（OR = 7.1）和 EAT（OR = 2.3）。
虽然 EAT 与 MetS 相关，并可识别心血管代谢风险增加的个体，但与当前风险标志物相比，其额外作用有限。
