title: Epicardial adipose tissue inflammation is related to vitamin D deficiency in patients affected by coronary artery disease.
abstract: OBJECTIVE
  Alterations in epicardial adipose tissue (EAT) biology (i.e. increased fat thickness and inflammation) have been described in coronary artery disease (CAD) patients. In addition to its classic role in the regulation of calcium-phosphate homeostasis, vitamin D may exert immune-regulatory and anti-inflammatory effects. Whether EAT inflammation may be linked to vitamin D deficiency is still unknown. In the present study we evaluated plasma 25-hydroxycholecalciferol (25OHD) level in CAD patients and its relationship with EAT ability to locally metabolize vitamin D, EAT expression of inflammation-related molecules and EAT thickness.
  
  
  RESULTS
  Plasma 25OHD level was quantified by an immunoluminometric assay. EAT expression of inflammation-related molecules (MCP-1, PTX3, TNFα, IL-6, adiponectin), vitamin D receptor (VDR), CYP27B1 (25OHD-activating enzyme) and CYP24A1 (1,25-dihydroxycholecalciferol-metabolizing enzyme) was performed by microarray. EAT thickness was quantified by echocardiography. Median plasma 25OHD level was 10.85 ng/mL and 83% of CAD patients displayed 25OHD level below 20 ng/mL. At decreasing plasma 25OHD concentration, we observed a down-regulation in CYP27B1 and CYP24A1 level and an increased expression of VDR and pro-inflammatory cytokines (MCP-1, PTX3, TNFα, IL-6) at EAT level. No correlation was observed between plasma 25OHD level and EAT thickness.
  
  
  CONCLUSIONS
  Our data suggest an increased activation of inflammatory pathways at EAT level possibly related to systemic and local vitamin D deficiency in CAD patients. Whether maintaining an optimal vitamin D status may be helpful to reduce EAT inflammation and to prevent CAD and its progression needs further investigation.
authors.affiliation: Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy. Electronic address: elena.dozio@unimi.it.
authors.forename: E
authors.initials: E
authors.lastname: Dozio
authors.affiliation: Diabetology and Metabolic Diseases Unit, I.R.C.C.S. Policlinico San Donato, San Donato Milanese, Milan, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Briganti
authors.affiliation: Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Vianello
authors.affiliation: Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Dogliotti
authors.affiliation: Department of Sciences for Health, Ospedale San Paolo, Università degli Studi di Milano, Milan, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Barassi
authors.affiliation: Diabetology and Metabolic Diseases Unit, I.R.C.C.S. Policlinico San Donato, San Donato Milanese, Milan, Italy.
authors.forename: A E
authors.initials: AE
authors.lastname: Malavazos
authors.affiliation: Diabetology and Metabolic Diseases Unit, I.R.C.C.S. Policlinico San Donato, San Donato Milanese, Milan, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Ermetici
authors.affiliation: Diabetology and Metabolic Diseases Unit, I.R.C.C.S. Policlinico San Donato, San Donato Milanese, Milan, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Morricone
authors.affiliation: Institute for Clinical Chemistry and Laboratory Medicine, University of Regensburg, Regensburg, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Sigruener
authors.affiliation: Institute for Clinical Chemistry and Laboratory Medicine, University of Regensburg, Regensburg, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Schmitz
authors.affiliation: Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy; Service of Laboratory Medicine 1 - Clinical Pathology, Department of Health Services of Diagnosis and Treatment - Laboratory Medicine, I.R.C.C.S. Policlinico San Donato, San Donato Milanese, Milan, Italy.
authors.forename: M M
authors.initials: MM
authors.lastname: Corsi Romanelli
mesh_terms: D015090:25-Hydroxyvitamin D3 1-alpha-Hydroxylase / Q000235:genetics / Q000378:metabolism; D052242:Adiponectin / Q000235:genetics / Q000378:metabolism; D000273:Adipose Tissue / Q000503:physiopathology*; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D001835:Body Weight; D002097:C-Reactive Protein / Q000235:genetics / Q000378:metabolism; D018932:Chemokine CCL2 / Q000235:genetics / Q000378:metabolism; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003324:Coronary Artery Disease / Q000097:blood / Q000150:complications / Q000503:physiopathology*; D015536:Down-Regulation; D006801:Humans; D007249:Inflammation / Q000150:complications / Q000503:physiopathology*; D015850:Interleukin-6 / Q000235:genetics / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D010496:Pericardium / Q000503:physiopathology*; D018167:Receptors, Calcitriol / Q000235:genetics / Q000378:metabolism; D000683:Serum Amyloid P-Component / Q000235:genetics / Q000378:metabolism; D014280:Triglycerides / Q000097:blood; D014409:Tumor Necrosis Factor-alpha / Q000235:genetics / Q000378:metabolism; D014807:Vitamin D / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood / Q000150:complications / Q000503:physiopathology*; D065668:Vitamin D3 24-Hydroxylase / Q000235:genetics / Q000378:metabolism; D000099153:Pentraxins
chemical_list: D015090:25-Hydroxyvitamin D3 1-alpha-Hydroxylase; D052242:Adiponectin; D001786:Blood Glucose; D002097:C-Reactive Protein; D018932:Chemokine CCL2; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D015850:Interleukin-6; D018167:Receptors, Calcitriol; D000683:Serum Amyloid P-Component; D014280:Triglycerides; D014409:Tumor Necrosis Factor-alpha; D014807:Vitamin D; D065668:Vitamin D3 24-Hydroxylase; D000099153:Pentraxins; C111835:CCL2 protein, human; C508600:IL6 protein, human; C585549:CYP24A1 protein, human; C000600378:CYP27B1 protein, human
keywords: CYP24A1; CYP27B1; Coronary artery disease; Epicardial adipose tissue; Inflammation; Vitamin D; Vitamin D receptor