title: Pericardial adipose tissue and coronary artery calcification in the Multi-ethnic Study of Atherosclerosis (MESA).
abstract: OBJECTIVE
  To examine the relationship of pericardial adipose tissue (PAT) with coronary artery calcification in the Multi-Ethnic Study of Atherosclerosis.
  
  
  METHODS
  The baseline cohort comprised 6,814 Caucasian (38%), African-American (28%), Chinese American (12%), and Hispanic (22%) adults aged 45-84, without known clinical cardiovascular disease. Cardiac CT was used to measure PAT (cm(3) ) and calcification (Agatston score). We examined cross-sectional associations of PAT with the presence (score >0) and severity (continuous score if >0) of calcification using prevalence ratio (PR) (n = 6,672) and linear regression (n = 3,362), respectively. Main models were adjusted for age, age(2) , gender, race/ethnicity, field site, smoking, physical activity, alcohol, and education.
  
  
  RESULTS
  PAT volume (adjusted for age, height, weight, and site) was greatest in Chinese males, whereas Black males had less PAT than all but Black females. PAT was associated with presence [PR per standard deviation (SD): 1.06 (95% CI: 1.04, 1.08)] and severity [difference in log Agatston score per SD: 0.15 (0.09, 0.21)] of calcification, but neither association varied by race/ethnicity. Adjustment for generalized adiposity attenuated but did not eliminate the associations. With further adjustment for traditional risk factors and inflammatory markers, only the association with severity remained statistically significant [PR: 1.02 (1.00, 1.04); difference: 0.10 (0.03, 0.17)]. Heterogeneity by sex was observed for the presence of calcification (PR in men: 1.04; in women: 1.08; P for interaction <0.0001).
  
  
  CONCLUSIONS
  PAT was associated with the presence and severity of coronary artery calcification in this cohort, but neither association varied by race/ethnicity.
authors.affiliation: Sticht Center on Aging, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA. jillmccl@wakehealth.edu
authors.forename: Jill
authors.initials: J
authors.lastname: McClain
authors.forename: Fang
authors.initials: F
authors.lastname: Hsu
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Brown
authors.forename: Gregory
authors.initials: G
authors.lastname: Burke
authors.forename: John
authors.initials: J
authors.lastname: Carr
authors.forename: Tamara
authors.initials: T
authors.lastname: Harris
authors.forename: Stephen
authors.initials: S
authors.lastname: Kritchevsky
authors.forename: Moyses
authors.initials: M
authors.lastname: Szklo
authors.forename: Russell
authors.initials: R
authors.lastname: Tracy
authors.forename: Jingzhong
authors.initials: J
authors.lastname: Ding
mesh_terms: D000273:Adipose Tissue / Q000000981:diagnostic imaging / Q000378:metabolism*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D050197:Atherosclerosis / Q000208:ethnology / Q000378:metabolism / Q000473:pathology; D044383:Black People; D002114:Calcinosis / Q000208:ethnology; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000208:ethnology / Q000473:pathology*; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000473:pathology*; D003430:Cross-Sectional Studies; D005006:Ethnicity; D005260:Female; D006801:Humans; D007249:Inflammation / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D010496:Pericardium / Q000000981:diagnostic imaging / Q000378:metabolism*; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D014057:Tomography, X-Ray Computed; D001741:Black or African American