title: Ethnic differences in the relationship between pericardial adipose tissue and coronary artery calcified plaque: African-American-diabetes heart study.
abstract: BACKGROUND
  Calcified atherosclerotic plaque (CP) is less prevalent and less severe in African-Americans (AA), relative to European Americans (EA). Because pericardial adipose tissue (PAT) is associated with CP in the neighboring coronary arteries, we explored ethnic-specific relationships between PAT and CP.
  
  
  METHODS
  PAT volume and coronary and aortic CP were measured in 561 EA and 575 AA subjects with type 2 diabetes using single and multidetector computed tomography. Generalized estimating equations with exchangeable correlation and the sandwich estimator of the variance were used to test for associations between PAT and CP.
  
  
  RESULTS
  Mean (sd) ages of AA and EA participants were 56.7 (9.5) and 62.0 (8.9) yr, respectively; diabetes duration was 10.5 (8.1) and 10.1 (7.3) yr; and PAT volume was 86.9 (38.6) and 131.7 (55.3) cm3/45 mm. In AA and EA participants, respectively, mean (sd) coronary CP mass scores were 803 (1,889) and 1,465 (2,847) mg calcium; and aortic CP, 5,407 (10,651) and 10,090 (15,087) mg calcium. Adjusting for age, gender, body mass index, blood pressure, height, smoking, lipid-lowering medications, C-reactive protein, albuminuria, high-density lipoprotein-cholesterol, and triglycerides, parameter estimates for the relationship between PAT and log(coronary CP+1) were 0.012 in AA (P<0.0001) and 0.003 (P=0.24) in EA, with a significant ethnic difference (P=0.019). No significant relationships or ethnic differences were observed between PAT and aortic CP (P=0.24, fully adjusted model).
  
  
  CONCLUSIONS
  Pericardial adiposity is strongly associated with coronary atherosclerosis in AA with type 2 diabetes. Novel cardiovascular disease risk factors such as PAT may contribute to ethnic disparities in susceptibility to development of coronary atherosclerosis.
authors.affiliation: Department of Public Health Sciences, Center for Diabetes Research, Section on Nephrology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina 27157-1053, USA.
authors.forename: Jasmin
authors.initials: J
authors.lastname: Divers
authors.forename: Lynne E
authors.initials: LE
authors.lastname: Wagenknecht
authors.forename: Donald W
authors.initials: DW
authors.lastname: Bowden
authors.forename: J Jeffrey
authors.initials: JJ
authors.lastname: Carr
authors.forename: R Caresse
authors.initials: RC
authors.lastname: Hightower
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Register
authors.forename: Jianzhao
authors.initials: J
authors.lastname: Xu
authors.forename: Carl D
authors.initials: CD
authors.lastname: Langefeld
authors.forename: Barry I
authors.initials: BI
authors.lastname: Freedman
mesh_terms: D000273:Adipose Tissue / Q000033:anatomy & histology*; D000368:Aged; D000419:Albuminuria / Q000453:epidemiology; D044383:Black People; D001786:Blood Glucose / Q000378:metabolism; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000208:ethnology*; D002118:Calcium / Q000097:blood; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000208:ethnology*; D003404:Creatinine / Q000097:blood; D048909:Diabetes Complications / Q000000981:diagnostic imaging / Q000208:ethnology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D003925:Diabetic Angiopathies / Q000453:epidemiology / Q000208:ethnology; D005006:Ethnicity; D005260:Female; D005919:Glomerular Filtration Rate; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D010496:Pericardium / Q000033:anatomy & histology*; D010758:Phosphorus / Q000097:blood; D011859:Radiography; D044465:White People; D001741:Black or African American
chemical_list: D001786:Blood Glucose; D002118:Calcium; D003404:Creatinine; D006442:Glycated Hemoglobin; D010758:Phosphorus
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