title: Epicardial adipose tissue and metabolic syndrome in hypertensive patients with normal body weight and waist circumference.
abstract: BACKGROUND
  Metabolic syndrome (MetS) is a cluster of risk factors, related to visceral adiposity, which is frequently observed in overweight patients. However, it has also been reported in normal weight subjects. Epicardial adipose tissue (EAT) is a visceral fat. The aim of the study was to evaluate whether EAT is associated with MetS in hypertensive patients with normal weight and waist.
  
  
  METHODS
  We studied 174 Caucasian hypertensive patients, aged ≥40 years, with body mass index (BMI) <25 kg/m(2) and waist circumference <102 cm in men and 88 cm in women. MetS was defined according to NCEP ATP III criteria, not including waist circumference. EAT was measured by echocardiography above the free wall of the right ventricle, at end diastole.
  
  
  RESULTS
  MetS was present in 21 (12%) patients. EAT was significantly higher in patients with MetS than in those without MetS, 4.0 ± 0.8 vs 2.5 ± 0.9 mm, P < 0.01, respectively, but BMI and waist circumference were not. Multivariate analysis showed that EAT was independently associated with MetS. Receiver operating characteristic (ROC) curve analysis showed that EAT significantly improved prediction of MetS when added to BMI and waist circumference. Indeed, the area under the curve improved from 0.63 (0.50-0.76) to 0.91 (0.87-0.96), and resulted significantly higher (P < 0.01). ROC curve for EAT alone indicated that the cutoff value of 3.1 mm had the best performance in predicting MetS, that is, 100% sensitivity and 79% specificity.
  
  
  CONCLUSIONS
  EAT thickness is associated with MetS in hypertensive patients with normal weight and waist.
authors.affiliation: Dipartimento di Medicina e Scienze dell'Invecchiamento, Università "Gabriele d'Annunzio," Chieti, Italy. pierdomenico@unich.it
authors.forename: Sante D
authors.initials: SD
authors.lastname: Pierdomenico
authors.forename: Anna M
authors.initials: AM
authors.lastname: Pierdomenico
authors.forename: Matteo
authors.initials: M
authors.lastname: Neri
authors.forename: Franco
authors.initials: F
authors.lastname: Cuccurullo
mesh_terms: D000328:Adult; D000368:Aged; D004452:Echocardiography; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D056865:Ideal Body Weight; D050152:Intra-Abdominal Fat / Q000473:pathology*; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000473:pathology*; D008875:Middle Aged; D010496:Pericardium / Q000473:pathology*; D012680:Sensitivity and Specificity; D055105:Waist Circumference