title: Associations of pericardial and intrathoracic fat with coronary calcium presence and progression in a multiethnic study.
abstract: OBJECTIVE
  Body mass index (BMI) may not accurately or adequately reflect body composition or its role in the development of cardiovascular disease (CVD). Ectopic adipose depots may provide a more refined representation of the role of adiposity in CVD. Thus, the association of pericardial and intra-thoracic fat with coronary artery calcium (CAC) was examined.
  
  
  METHODS
  Nearly 600 white men and women, as well as Filipina women and African-American women, all without known CVD, had abdominal and chest computed tomography (CT) scans at two time points about 4 years apart from which CAC presence, severity and progression, as well as pericardial and intrathoracic fat volumes were obtained. Logistic and linear regression models with staged adjustment were used to assess associations of pericardial and intra-thoracic fat with CAC presence, severity, and progression.
  
  
  RESULTS
  After adjustment for age, BMI, sex/ethnic group, ever smoking, and lipids, each standard deviation higher increment of intra-thoracic fat, but not pericardial fat, was significantly associated with 3.84-fold higher odds of prevalent CAC (95% CI (1.54, 9.58), P = 0.004) and a 38.4% higher CAC score (95% CI (3.5%, 90.0%), P = 0.03). Neither pericardial nor intrathoracic fat were associated with CAC progression.
  
  
  CONCLUSIONS
  Contrary to previous reports, pericardial fat was not associated with the presence, severity or progression of CAC. However, a significant association between intrathoracic fat and both the presence and severity of CAC was demonstrated. Studies measuring fat in the thoracic cavity may consider defining intrathoracic fat as a separate entity from pericardial fat.
authors.affiliation: Division of Preventive Medicine, Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, California, USA.
authors.forename: Christina L
authors.initials: CL
authors.lastname: Wassel
authors.forename: Gail A
authors.initials: GA
authors.lastname: Laughlin
authors.forename: Maria Rosario G
authors.initials: MR
authors.lastname: Araneta
authors.forename: Eugene
authors.initials: E
authors.lastname: Kang
authors.forename: Cindy M
authors.initials: CM
authors.lastname: Morgan
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Barrett-Connor
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Allison
mesh_terms: D054392:Adipokines / Q000378:metabolism; D000273:Adipose Tissue / Q000000981:diagnostic imaging; D050154:Adiposity; D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D015992:Body Mass Index; D002118:Calcium / Q000378:metabolism*; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging / Q000209:etiology; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000473:pathology*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000150:complications / Q000000981:diagnostic imaging; D010496:Pericardium / Q000000981:diagnostic imaging / Q000378:metabolism*; D011446:Prospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D044465:White People
chemical_list: D054392:Adipokines; D002118:Calcium