title: Relation of epicardial fat and alanine aminotransferase in subjects with increased visceral fat.
abstract: BACKGROUND
  Increased visceral adipose tissue (VAT) is a risk factor for an unfavorable cardio-metabolic profile and fatty liver. Individuals with human immunodeficiency virus (HIV) on highly active antiretroviral therapy (HAART) can be associated with metabolic syndrome (MS) and higher visceral fat. However, the potential link between cardiac adiposity, emerging index of visceral adiposity, and fatty liver is still unexplored.
  
  
  OBJECTIVE
  To evaluate whether echocardiographic epicardial adipose tissue, index of cardiac adiposity, could be related to serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) activity, surrogate markers of fatty liver, in HIV-infected patients with (HIV+MS+) and without HAART-associated MS (HIV+MS-).
  
  
  METHODS
  This was a cross-sectional observational study on 57 HIV+MS+ patients, 52 HIV+MS- and 57 HIV-negative subjects with MS (HIV-MS+), as control group. Epicardial fat thickness and intra-abdominal VAT were obtained by echocardiography and magnetic resonance imaging (MRI), respectively. Serum ALT and AST activity, plasma adiponectin levels, and MS biochemical parameters were measured.
  
  
  RESULTS
  Echocardiographic epicardial fat thickness was correlated with MRI-VAT (r = 0.83, P < 0.01), AST/ALT ratio (r = 0.77, P < 0.01), ALT (r = 0.58, P < 0.01), AST (r = 0.56, P < 0.01), and adiponectin (r = -0.45, P < 0.01) in HIV+MS+. MRI-VAT and AST/ALT ratio were the best correlates of epicardial fat thickness (r (2) = 0.45, P < 0.01).
  
  
  CONCLUSIONS
  This study shows for the first time a clear relationship of epicardial fat, index of cardiac and visceral adiposity, and serum ALT and AST activity, markers of fatty liver, in subjects with increased visceral adiposity and cardio-metabolic risk. This correlation seems to be independent of overall adiposity and rather function of excess visceral adiposity.
authors.affiliation: Division of Endocrinology and Metabolism, Department of Medicine, McMaster University, Hamilton, Ontario, Canada. gianluca.iaco@tin.it
authors.forename: Gianluca
authors.initials: G
authors.lastname: Iacobellis
authors.forename: Adriano M
authors.initials: AM
authors.lastname: Pellicelli
authors.forename: Benvenuto
authors.initials: B
authors.lastname: Grisorio
authors.forename: Giorgio
authors.initials: G
authors.lastname: Barbarini
authors.forename: Frida
authors.initials: F
authors.lastname: Leonetti
authors.forename: Arya M
authors.initials: AM
authors.lastname: Sharma
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Barbaro
mesh_terms: D050154:Adiposity; D000293:Adolescent; D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood*; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects; D001219:Aspartate Aminotransferases / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D004452:Echocardiography; D005234:Fatty Liver / Q000097:blood / Q000175:diagnosis / Q000473:pathology; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy / Q000473:pathology; D006801:Humans; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging* / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000139:chemically induced / Q000473:pathology; D008875:Middle Aged; D010496:Pericardium / Q000000981:diagnostic imaging* / Q000473:pathology*; D012044:Regression Analysis
chemical_list: D015415:Biomarkers; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase