title: Relationship of pericardial fat with biomarkers of inflammation and hemostasis, and cardiovascular disease: the Multi-Ethnic Study of Atherosclerosis.
abstract: OBJECTIVE
  Pericardial fat may increase the risk of cardiovascular disease (CVD) by increasing circulating levels of inflammation and hemostasis biomarkers. We investigated the associations of pericardial fat with inflammation and hemostasis biomarkers, as well as incident CVD events, and whether there are any ethnic differences in these associations.
  
  
  METHODS
  We analyzed results from 6415 participants from the Multi-Ethnic Study of Atherosclerosis who had measurements of pericardial fat volume and circulating levels of C-reactive protein (CRP), fibrinogen, interleukin (IL)-6, factor VIII, D-dimer and plasmin-antiplasmin complex (PAP), and had a mean follow-up period of 9.5 years. Incident CVD event was defined as any adjudicated CVD event.
  
  
  RESULTS
  After adjusting for confounding factors, pericardial fat volume was positively associated with natural log (ln) of IL-6 levels, but inversely associated with ln D-dimer and ln PAP levels (β = 0.067, -0.032, and -0.105 respectively, all P < 0.05). Although a larger pericardial fat volume was associated with a higher risk of incident CVD, the association was attenuated to borderline significance after adjusting for traditional cardiovascular risk factors (P = 0.050). There was a borderline significant ethnicity interaction (P = 0.080), whereby the association between pericardial fat volume and incident CVD was significant in Hispanic Americans, even after further adjusting for biomarkers of inflammation and hemostasis (hazard ratio = 1.31 per SD increase, 95% confidence interval 1.09-1.57, P = 0.004).
  
  
  CONCLUSIONS
  Pericardial fat was associated with several inflammation and hemostasis biomarkers. The association of pericardial fat with incident CVD events was independent of these biomarkers only among Hispanic Americans.
authors: Centre for Vascular Research, University of New South Wales, Sydney, NSW, Australia; Faculty of Medicine, University of Sydney, Sydney, NSW, Australia. Electronic address: oklws@yahoo.com.hk.
authors: Kwok-Leung
authors: KL
authors: Ong
authors: Sticht Center on Aging, Wake Forest University School of Medicine, Winston-Salem, NC, United States.
authors: Jingzhong
authors: J
authors: Ding
authors: Department of Biostatistics, University of Washington, Seattle, WA, United States.
authors: Robyn L
authors: RL
authors: McClelland
authors: Department of Medicine, University of Hong Kong, Hong Kong, China.
authors: Bernard M Y
authors: BM
authors: Cheung
authors: Department of Family and Preventive Medicine, University of California San Diego, La Jolla, CA, United States.
authors: Michael H
authors: MH
authors: Criqui
authors: Centre for Vascular Research, University of New South Wales, Sydney, NSW, Australia; Faculty of Medicine, University of Sydney, Sydney, NSW, Australia.
authors: Philip J
authors: PJ
authors: Barter
authors: Centre for Vascular Research, University of New South Wales, Sydney, NSW, Australia; Faculty of Medicine, University of Sydney, Sydney, NSW, Australia.
authors: Kerry-Anne
authors: KA
authors: Rye
authors: Department of Family and Preventive Medicine, University of California San Diego, La Jolla, CA, United States.
authors: Matthew A
authors: MA
authors: Allison
mesh_terms: D000273:Adipose Tissue / Q000378:metabolism*; D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000208:ethnology / Q000503:physiopathology*; D015415:Biomarkers / Q000378:metabolism*; D002097:C-Reactive Protein / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000097:blood / Q000503:physiopathology; D015331:Cohort Studies; D005006:Ethnicity; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism; D005341:Fibrinolysin / Q000378:metabolism; D005500:Follow-Up Studies; D006487:Hemostasis; D006630:Hispanic or Latino; D006801:Humans; D007249:Inflammation / Q000473:pathology; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010496:Pericardium / Q000378:metabolism*; D016016:Proportional Hazards Models
chemical_list: D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; D015850:Interleukin-6; C036309:fibrin fragment D; D002097:C-Reactive Protein; D005341:Fibrinolysin
keywords: Biomarkers; Cardiovascular disease; Hemostasis; Inflammation; Pericardial fat