Epicardial adipose tissue relating to anthropometrics, metabolic derangements and fatty liver disease independently contributes to serum high-sensitivity C-reactive protein beyond body fat composition: a study validated with computed tomography.
BACKGROUND
Epicardial adipose tissue (EAT) measured by echocardiography has been proposed to be associated with metabolic syndrome and increased cardiovascular risks. However, its independent association with fatty liver disease and systemic inflammation beyond clinical variables and body fat remains less well known.


METHODS
The relationships between EAT and various factors of metabolic derangement were retrospectively examined in consecutive 359 asymptomatic subjects (mean age, 51.6 years; 31% women) who participated in a cardiovascular health survey. Echocardiography-derived regional EAT thickness from parasternal long-axis and short-axis views was quantified. A subset of data from 178 randomly chosen participants were validated using 16-slice multidetector computed tomography. Body fat composition was evaluated using bioelectrical impedance from foot-to-foot measurements.


RESULTS
Increased EAT was associated with increased waist circumference, body weight, and body mass index (all P values for trend = .005). Graded increases in serum fasting glucose, insulin resistance, and alanine transaminase levels were observed across higher EAT tertiles as well as a graded decrease of high-density lipoprotein (all P values for trend <.05). The areas under the receiver operating characteristic curves for identifying metabolic syndrome and fatty liver disease were 0.8 and 0.77, with odds ratio estimated at 3.65 and 2.63, respectively. In a multivariate model, EAT remained independently associated with higher high-sensitivity C-reactive protein and fatty liver disease.


CONCLUSIONS
These data suggested that echocardiography-based epicardial fat measurement can be clinically feasible and was related to several metabolic abnormalities and independently associated fatty liver disease. In addition, EAT amount may contribute to systemic inflammation beyond traditional cardiovascular risks and body fat composition.
Division of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan.
Yau-Huei
YH
Lai
Chun-Ho
CH
Yun
Fei-Shih
FS
Yang
Chuan-Chuan
CC
Liu
Yih-Jer
YJ
Wu
Jen-Yuan
JY
Kuo
Hung-I
HI
Yeh
Tin-Yu
TY
Lin
Hiram G
HG
Bezerra
Shou-Chuan
SC
Shih
Cheng-Ho
CH
Tsai
Chung-Lieh
CL
Hung
D000273:Adipose Tissue / Q000000981:diagnostic imaging*; D000886:Anthropometry; D015415:Biomarkers / Q000097:blood; D050218:Body Fat Distribution / Q000379:methods*; D002097:C-Reactive Protein / Q000032:analysis; D015897:Comorbidity; D005234:Fatty Liver / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D008875:Middle Aged; D010496:Pericardium / Q000000981:diagnostic imaging*; D015995:Prevalence; D015203:Reproducibility of Results; D018570:Risk Assessment; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013223:Statistics as Topic; D013624:Taiwan / Q000453:epidemiology; D014463:Ultrasonography
D015415:Biomarkers; D002097:C-Reactive Protein