Thompson Randall C, Trumble Benjamin C, Cummings Daniel K, Neunuebel Angela D, Hooper Paul L, Wann Samuel, Allam Adel H, Neunuebel Frances, Gans Benjamin D, King Samantha I, Seabright Edmond, Finch Caleb E, Gatz Margaret, Buetow Kenneth, Miyamoto Michael I, Lombardi Guido P, Sutherland M Linda, Sutherland James D, Ward Christopher, Lee Madeleine J, Mahadev Ashna, Rodriguez Daniel Eid, Michalik David E, Rowan Chris J, Cao Tianyu, Stieglitz Jonathan, Quick Cameron M, Thomas Gregory S, Narula Jagat, Dey Damini, Gurven Michael, Kaplan Hillard
St Luke's Mid-America Heart Institute of Kansas City, Kansas City, MO, USA.
University of Missouri - Kansas City, Kansas City, MO, USA.
Am J Prev Cardiol. 2025 Aug 22;23:101271. doi: 10.1016/j.ajpc.2025.101271. eCollection 2025 Sep.
Greater deposits of epicardial adipose tissue are associated with atrial fibrillation and coronary disease, but have not been studied in subsistence populations.
We performed CT imaging to measure coronary artery and thoracic aortic calcium (CAC, TAC), epicardial fat thickness (EFT), liver density, and left atrial (LA) anteroposterior diameter and, using a deep learning-enabled software program, epicardial and thoracic fat volume (EFV, TFV), in two remote Amerindian subsistence populations with minimal coronary artery calcification and virtually no atrial fibrillation. We compared 893 adult Tsimane (mean age 58.3±10.5 y, 51.6% male), 440 Moseten (55.9±10.4 y, 53.6% male) to 955 U.S. (56.8±10.8 y, 51.6% male) subjects.
Tsimane and Moseten had 43%-52% lower EFT, EFV, TFV, and 48-92% less CAC and TAC, respectively than the U.S. cohort. Mean liver measurements were 14-22% denser and LA diameters 10-14% larger (≈ 40% larger by volume). For EFV, Tsimane, Moseten, and U.S. cohorts averaged 54.2±25.6, 60.3±35.1, and 106±53.5 cc, respectively (p< 0.05 for all comparisons). EFV remained significantly smaller after adjustment for age, BMI, and other characteristics. For all CT metrics, the more acculturated Moseten measures were intermediate between Tsimane and the U.S. cohort.
Tsimane mean EFV was the lowest of any population ever reported in the literature, achieving a new population standard. The low levels of EFV in the Tsimane and Moseten add to the body of evidence linking ectopic fat and atherosclerosis and further confirm (in the negative) the association, and likely causative role, of epicardial fat and atrial fibrillation.
心外膜脂肪组织的大量沉积与心房颤动和冠状动脉疾病相关，但尚未在自给自足的人群中进行研究。
我们对两个冠状动脉钙化极少且几乎没有心房颤动的偏远美洲印第安自给自足人群进行了CT成像，以测量冠状动脉和胸主动脉钙化（CAC、TAC）、心外膜脂肪厚度（EFT）、肝脏密度以及左心房（LA）前后径，并使用启用深度学习的软件程序测量心外膜和胸部脂肪体积（EFV、TFV）。我们将893名成年齐曼人（平均年龄58.3±10.5岁，51.6%为男性）、440名莫塞滕人（55.9±10.4岁，53.6%为男性）与955名美国受试者（56.8±10.8岁，51.6%为男性）进行比较。
齐曼人和莫塞滕人的EFT、EFV、TFV分别比美国队列低43%-52%，CAC和TAC分别少48%-92%。肝脏平均测量值密度高14%-22%，LA直径大10%-14%（按体积计算约大40%）。对于EFV，齐曼人、莫塞滕人和美国队列的平均值分别为54.2±25.6、60.3±35.1和106±53.5立方厘米（所有比较p<0.05）。在调整年龄、BMI和其他特征后，EFV仍然显著较小。对于所有CT指标，文化适应程度较高的莫塞滕人的测量值介于齐曼人和美国队列之间。
齐曼人的平均EFV是文献中报道的所有人群中最低的，达到了新的人群标准。齐曼人和莫塞滕人心外膜脂肪含量低进一步证明了异位脂肪与动脉粥样硬化之间的联系，并进一步（从反面）证实了心外膜脂肪与心房颤动之间的关联及其可能的因果作用。
