title: Association between carotid intima-media thickness and pericardial fat in the Multi-Ethnic Study of Atherosclerosis (MESA).
abstract: BACKGROUND
  Carotid intima-media thickness (IMT) is a subclinical marker of atherosclerosis and a strong predictor of stroke. Pericardial fat (PF), the fat depot around the heart, has been associated with several atherosclerosis risk factors. We sought to examine the association between carotid IMT and PF, and to examine whether such an association is independent from common atherosclerosis risk factors including measures of overall adiposity.
  
  
  METHODS
  Unadjusted and multivariable-adjusted linear regression analysis was used to examine associations between common carotid artery (CCA) IMT and internal carotid artery (ICA) IMT with PF in a random sample of 996 participants from the Multi-Ethnic Study of Atherosclerosis (MESA) who underwent carotid ultrasound and chest computed tomography at baseline examination.
  
  
  RESULTS
  A significant positive correlation was observed between PF and CCA-IMT (r=0.27, P < .0001) and ICA-IMT (r=0.17, P < .0001). In an unadjusted sex-specific linear regression analysis, there was a significant association between PF (1-SD difference) and CCA-IMT (mm) in both women (beta coefficient [95% confidence interval]: 0.06 [0.04, 0.08], P < .0001) and men (0.03 [0.01, 0.05], P < .0002), an association that persisted after further adjusting for age and ethnicity (0.02 [+0.00, 0.04], P=.0120 for women, and 0.02 [+0.00, 0.03], P=.0208 for men). However, after additional adjustment for atherosclerosis risk factors and either body mass index or waist circumference, these relations were no longer significant in either sex. In similar analyses, PF was significantly associated with ICA-IMT in both men (0.11 [0.06, 0.15], P < .0001) and women (0.08 [0.02, 0.13], P=.0041). These relations were no longer significant in women in multivariable-adjusted models, but persisted in men in all models except after adjusting for age, ethnicity, and waist circumference.
  
  
  CONCLUSIONS
  In the general population PF is associated with carotid IMT, an association that possibly is not independent from markers of overall adiposity or common atherosclerosis risk factors.
authors.affiliation: Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston Salem, North Carolina 27104, USA. esoliman@wfubmc.edu
authors.forename: Elsayed Z
authors.initials: EZ
authors.lastname: Soliman
authors.forename: Jingzhong
authors.initials: J
authors.lastname: Ding
authors.forename: Fang-Chi
authors.initials: FC
authors.lastname: Hsu
authors.forename: J Jeffrey
authors.initials: JJ
authors.lastname: Carr
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Polak
authors.forename: David C
authors.initials: DC
authors.lastname: Goff
mesh_terms: D000273:Adipose Tissue / Q000000981:diagnostic imaging / Q000473:pathology*; D050154:Adiposity / Q000208:ethnology; D000368:Aged; D050197:Atherosclerosis / Q000150:complications / Q000208:ethnology / Q000473:pathology* / Q000503:physiopathology; D015992:Body Mass Index; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000473:pathology*; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000473:pathology*; D002561:Cerebrovascular Disorders / Q000208:ethnology / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010496:Pericardium / Q000000981:diagnostic imaging / Q000473:pathology*; D018570:Risk Assessment; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000473:pathology*; D017540:Tunica Media / Q000000981:diagnostic imaging / Q000473:pathology*; D014463:Ultrasonography; D014481:United States; D055105:Waist Circumference