Erdoğan Turan, Durakoğlugil Murtaza Emre, Çetin Mustafa, Altan Kocaman Sinan, Duman Hakan, Çiçek Yüksel, Şatıroğlu Ömer
Faculty of Medicine, Department of Cardiology, Recep Tayyip Erdogan University, Rize.
Department of Cardiology, Ankara Medicana Hospital, Ankara, Turkey.
Acta Cardiol Sin. 2019 Jan;35(1):32-41. doi: 10.6515/ACS.201901_35(1).20180628A.
Visceral obesity is strongly associated with atherosclerosis. Even though waist circumference (WC) is the most common assessment method of total visceral adipose tissue and cardiometabolic risk, this method lacks direct measurement of adipose tissue and has better correlation to subcutaneous fat rather than visceral fat. We intended to investigate whether epicardial adipose tissue (EAT) is clinically superior to body mass index (BMI) and WC in predicting Framingham risk score (FRS) and carotid intima-media thickness (CIMT).
Our study included 331 patients who were admitted to our outpatient clinic for risk factor assessment. We calculated BMI, FRS, and WC, and the patients underwent echocardiographic and carotid examinations to measure EAT and CIMT. The metabolic syndrome (MS) score was calculated by summing the MS risk factor scores.
The area under the curve values of EAT were similar to FRS and higher than those of weight, BMI, and WC for both increased CIMT and the presence of carotid plaque. Male gender, age, low-density lipoprotein-cholesterol level, and EAT thickness were independent predictors of CIMT, whereas male gender, age, WC, uric acid concentration, and EAT significantly predicted the presence of carotid plaque.
This study demonstrated that epicardial adipose tissue (EAT) has a stronger correlation with CIMT than BMI and WC, and it was a significant predictor of increased CIMT and the presence of carotid plaque. Additional data are required to clarify the diagnostic and therapeutic role of EAT in managing obese patients, and to decrease their cardiometabolic risk.
内脏肥胖与动脉粥样硬化密切相关。尽管腰围（WC）是评估内脏脂肪总量和心脏代谢风险最常用的方法，但该方法缺乏对脂肪组织的直接测量，且与皮下脂肪的相关性优于内脏脂肪。我们旨在研究在心外膜脂肪组织（EAT）预测弗雷明汉风险评分（FRS）和颈动脉内膜中层厚度（CIMT）方面，是否在临床上优于体重指数（BMI）和腰围（WC）。
我们的研究纳入了331名因风险因素评估而入住门诊的患者。我们计算了BMI、FRS和WC，并对患者进行了超声心动图和颈动脉检查以测量EAT和CIMT。通过将代谢综合征（MS）风险因素评分相加来计算MS评分。
对于CIMT增加和颈动脉斑块的存在，EAT的曲线下面积值与FRS相似，且高于体重、BMI和WC的曲线下面积值。男性、年龄、低密度脂蛋白胆固醇水平和EAT厚度是CIMT的独立预测因素，而男性、年龄、WC、尿酸浓度和EAT显著预测了颈动脉斑块的存在。
本研究表明，心外膜脂肪组织（EAT）与CIMT的相关性比BMI和WC更强，并且是CIMT增加和颈动脉斑块存在的重要预测因素。需要更多数据来阐明EAT在管理肥胖患者中的诊断和治疗作用，并降低他们的心脏代谢风险。
