title: Epicardial adipose tissue, hepatic steatosis and obesity.
abstract: OBJECTIVE
  Hepatic steatosis is a common companion of obesity. Moreover, the measurement of epicardial adipose tissue (EAT) has been reported to be related with both obesity and insulin resistance. Therefore, we aimed to evaluate the relationship between hepatic steatosis, EAT and insulin resistance in obese patients.
  
  
  METHODS
  Sixty-three obese subjects were enrolled in the study. Patients were divided into 3 groups according to body mass index (BMI) as follows: 20 patients with 30 < or = BMI < 35 kg/m2 (Group 1, mean age 39.3+/-12.9 yr), 25 patients with 35 < or = BMI < 40 kg/m2 (Group 2, mean age 41.7+/-9.3 yr), and 18 patients with BMI > or = 40 kg/m2 (Group 3, mean age 36.8+/-13.9 yr). EAT and grade of hepatic steatosis were assessed sonographically. Anthropometrical measurements were assessed with the foot-to-foot bioelectrical impedance analysis. Insulin resistance was assessed according to basal insulin, quantitative insulin sensitivity check index (QUICKI) and homeostasis model assessment (HOMA) equations.
  
  
  RESULTS
  Although EAT was similarly higher in both groups 2 and 3, these groups were found to be similar in terms of the grade of hepatic steatosis. Both EAT and the grade of hepatic steatosis were correlated with whole body fat mass, abdominal adiposity, insulin resistance, and triglyceridemia but waist circumference was the only factor affecting EAT thickness. Highly sensitive C-reactive protein (hsCRP) was the only metabolic parameter that was significantly higher in Group 3 than in Group 1 (p=0.02).
  
  
  CONCLUSIONS
  Hepatic steatosis should be assessed as a valuable predictor that reflects the increments of whole body fat mass as well as abdominal adiposity. However, in an attempt to demonstrate marginal differences between patients with similar obesity levels, epicardial adipose tissue appears to be a more sensitive marker compared to hepatic steatosis.
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, University of Inonu, 44315 Malatya, Turkey. acikim@hotmail.com
authors.forename: A Sertkaya
authors.initials: AS
authors.lastname: Cikim
authors.forename: E
authors.initials: E
authors.lastname: Topal
authors.forename: M
authors.initials: M
authors.lastname: Harputluoglu
authors.forename: L
authors.initials: L
authors.lastname: Keskin
authors.forename: Z
authors.initials: Z
authors.lastname: Zengin
authors.forename: K
authors.initials: K
authors.lastname: Cikim
authors.forename: R
authors.initials: R
authors.lastname: Ozdemir
authors.forename: M
authors.initials: M
authors.lastname: Aladag
authors.forename: S
authors.initials: S
authors.lastname: Yologlu
mesh_terms: D000273:Adipose Tissue / Q000033:anatomy & histology / Q000473:pathology / Q000502:physiology; D000328:Adult; D000886:Anthropometry; D015992:Body Mass Index; D005234:Fatty Liver / Q000473:pathology / Q000503:physiopathology*; D005260:Female; D006321:Heart / Q000033:anatomy & histology*; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology; D008875:Middle Aged; D009765:Obesity / Q000473:pathology / Q000503:physiopathology*; D012307:Risk Factors; D013223:Statistics as Topic