男性和女性冠心病患者与非冠心病患者的冠状动脉周围和心外膜脂肪测量值的关系。
Relationships of pericoronary and epicardial fat measurements in male and female patients with and without coronary artery disease.
机构信息
University of Groningen, University Medical Center Groningen, Department of Radiology, the Netherlands; Affiliated Hospital of Nanjing University of Chinese Medicine, Department of Radiology, China; Jiangsu Province Hospital of Chinese Medicine, Department of Radiology, China.
Emory University, School of Medicine, Department of Radiology and Imaging Sciences, Atlanta, GA, USA.
出版信息
Eur J Radiol. 2023 Dec;169:111154. doi: 10.1016/j.ejrad.2023.111154. Epub 2023 Oct 18.
INTRODUCTION
Although pericoronary adipose tissue (PCAT) is a component of the epicardial adipose tissue (EAT) depot, they may have different associations to coronary artery disease (CAD). We explored relationships between pericoronary adipose tissue mean attenuation (PCAT) and EAT measurements in coronary CT angiography (CCTA) in patients with and without CAD.
MATERIAL AND METHODS
CCTA scans of 185 non-CAD and 81 CAD patients (86.4% >50% stenosis) were included and retrospectively analyzed. PCAT and EAT density/volume were measured and analyzed by sex, including associations with age, risk factors and tube voltage using linear regression models.
RESULTS
In non-CAD and CAD, mean PCAT and EAT volume were higher in men than in women (non-CAD: -92.5 ± 10.6HU vs -96.2 ± 8.4HU, and 174.4 ± 69.1 cm vs 124.1 ± 57.3 cm; CAD: -92.2 ± 9.0HU vs -97.4 ± 9.7HU, and 193.6 ± 62.5 cm vs 148.5 ± 50.5 cm (p < 0.05)). EAT density was slightly lower in men than women in non-CAD (-96.4 ± 6.3HU vs -94.4 ± 5.5HU (p < 0.05)), and similar in CAD (-98.2 ± 5.2HU vs 98.2 ± 6.4HU). There was strong correlation between PCAT and EAT density (non-CAD: r = 0.725, p < 0.001, CAD: r = 0.686, p < 0.001) but no correlation between PCAT and EAT volume (non-CAD: r = 0.018, p = 0.81, CAD: r = -0.055, p = 0.63). A weak inverse association was found between EAT density and EAT volume (non-CAD: r = -0.244, p < 0.001, CAD: r = -0.263, p = 0.02). In linear regression models, EAT density was significantly associated with PCAT in both non-CAD and CAD patients independent of risk factors and tube voltage.
CONCLUSION
In CAD and non-CAD patients, EAT density, but not EAT volume, showed significant associations with PCAT. Compared to women, men had higher PCAT and EAT volume independently of disease status, but similar or slightly lower EAT density. Differences in trends and relations of PCAT and EAT by sex could indicate that personalized interpretation and thresholding is needed.
简介
虽然冠状动脉周围脂肪组织（PCAT）是心外膜脂肪组织（EAT）库的一个组成部分，但它们可能与冠状动脉疾病（CAD）有不同的关联。我们探讨了 CAD 和非 CAD 患者冠状动脉 CT 血管造影（CCTA）中 PCAT 和 EAT 测量之间的关系。
材料和方法
纳入了 185 例非 CAD 和 81 例 CAD 患者（86.4% >50%狭窄）的 CCTA 扫描，进行回顾性分析。测量 PCAT 和 EAT 密度/体积，并按性别进行分析，包括与年龄、危险因素和管电压的相关性，采用线性回归模型进行分析。
结果
在非 CAD 和 CAD 患者中，男性的平均 PCAT 和 EAT 体积均高于女性（非 CAD：-92.5±10.6HU 与-96.2±8.4HU，174.4±69.1cm 与 124.1±57.3cm；CAD：-92.2±9.0HU 与-97.4±9.7HU，193.6±62.5cm 与 148.5±50.5cm（p<0.05））。非 CAD 患者中男性的 EAT 密度略低于女性（-96.4±6.3HU 与-94.4±5.5HU（p<0.05）），而 CAD 患者中的 EAT 密度则相似（-98.2±5.2HU 与 98.2±6.4HU）。PCAT 与 EAT 密度之间存在很强的相关性（非 CAD：r=0.725，p<0.001，CAD：r=0.686，p<0.001），但与 EAT 体积之间没有相关性（非 CAD：r=0.018，p=0.81，CAD：r=-0.055，p=0.63）。EAT 密度与 EAT 体积之间存在较弱的负相关（非 CAD：r=-0.244，p<0.001，CAD：r=-0.263，p=0.02）。在线性回归模型中，EAT 密度与 PCAT 之间存在显著相关性，在 CAD 和非 CAD 患者中均独立于危险因素和管电压。
结论
在 CAD 和非 CAD 患者中，EAT 密度而非 EAT 体积与 PCAT 有显著关联。与女性相比，男性的 PCAT 和 EAT 体积无论疾病状况如何都较高，但 EAT 密度相似或略低。PCAT 和 EAT 性别差异的趋势和关系可能表明需要进行个性化解释和阈值设置。
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