title: Epicardial adipose tissue thickness and plasma homocysteine in patients with metabolic syndrome and normal coronary arteries.
abstract: BACKGROUND
  Increased epicardial adipose tissue thickness and plasma homocysteine levels are associated with Metabolic Syndrome (MS) and coronary artery disease. The majority of patients with MS have subclinical or manifest coronary artery disease. The aim of this study was to evaluate the relationship between MS and plasma homocysteine levels and epicardial adipose tissue thickness in subjects without epicardial coronary artery disease.
  
  
  METHODS
  Patients who underwent coronary angiography due to angina or equivocal symptoms and/or abnormal stress test results and were found to have normal coronary arteries were evaluated for the presence of MS. The study group comprised 75 patients with normal coronary arteries and MS, and the control group included 75 age-gender matched subjects without coronary artery disease or MS.
  
  
  RESULTS
  Epicardial adipose tissue thickness (5.8 ± 1.9 mm vs. 4.3 ± 1.6 mm, p <0.001) and plasma homocysteine levels (21.6 ± 6.1 μmol/L vs. 15.1 ± 5.8 μmol/L, p <0.001) were significantly higher in the MS group. Body mass index, triglyceride level, weight, age and waist circumference were positively and HDL cholesterol level were negatively correlated with both epicardial adipose tissue thickness and plasma homocysteine level. Epicardial adipose tissue thickness had the strongest correlation with plasma homocysteine level (r = 0.584, p < 0.001). For each 1 mm increase in epicardial adipose tissue thickness, an increase of 3.51 μmol/L (95% CI: 2.24-4.79) in plasma homocysteine level was expected.
  
  
  CONCLUSIONS
  We observed a close relationship between MS and epicardial adipose tissue thickness and plasma homocysteine levels, even in the absence of overt coronary artery disease.
authors.affiliation: Department of Cardiology, Medical and Research Center of Alanya, Başkent University, Saray Mh. Yunus Emre Cad. No:1, 07400, Alanya, Antalya, Turkey.
authors.forename: Akif Serhat
authors.initials: AS
authors.lastname: Balcioğlu
authors.affiliation: Department of Cardiology, Faculty of Medicine, Recep Tayyip Erdoğan University, Rize, Turkey.
authors.forename: Murtaza Emre
authors.initials: ME
authors.lastname: Durakoğlugil
authors.affiliation: Department of Cardiology, Medical and Research Center of Alanya, Başkent University, Saray Mh. Yunus Emre Cad. No:1, 07400, Alanya, Antalya, Turkey.
authors.forename: Davran
authors.initials: D
authors.lastname: Ciçek
authors.affiliation: Department of Cardiology, Faculty of Medicine, Başkent University, Ankara, Turkey.
authors.forename: Uğur Abbas
authors.initials: UA
authors.lastname: Bal
authors.affiliation: Department of Cardiology, Faculty of Medicine, Gazi University, Ankara, Turkey.
authors.forename: Bülent
authors.initials: B
authors.lastname: Boyaci
authors.affiliation: Department of Cardiology, Faculty of Medicine, Başkent University, Ankara, Turkey.
authors.forename: Haldun
authors.initials: H
authors.lastname: Müderrisoğlu
keywords: Angina pectoris; Coronary angiography; Epicardial fat; Homocysteine