title: Epicardial fat volume is related to atherosclerotic calcification in multiple vessel beds.
abstract: OBJECTIVE
  To investigate relationships between epicardial fat volume and atherosclerosis in multiple major vessel beds.
  
  
  RESULTS
  From the population-based Rotterdam Study, 2298 participants underwent computed tomography examinations to quantify epicardial fat volume and atherosclerotic calcification volume in the coronary arteries, aortic arch, and extracranial and intracranial internal carotid arteries. Using linear regression modelling, we investigated relationships of epicardial fat volume with atherosclerotic calcification volume in each vessel bed, adjusting for conventional cardiovascular risk factors (waist circumference, systolic and diastolic blood pressure, total and high-density lipoprotein cholesterol, smoking, diabetes, and usage of blood pressure-lowering and lipid-lowering medication). To test whether associations of epicardial fat with calcification per vessel bed were independent of calcification elsewhere, we created a model in which all vessel beds were entered together. We found that a larger epicardial fat volume was associated with larger calcification volumes in the coronary arteries, aortic arch, and extracranial carotid arteries in both sexes. After adjustment for cardiovascular risk factors, larger epicardial fat volume was related to coronary and extracranial carotid artery calcification volume in males only [difference in calcification volume per SD increase in epicardial fat volume: 0.12 (95% confidence interval, CI: 0.04; 0.19) and 0.14 (95% CI: 0.06; 0.22)]. These associations remained unchanged after entering all vessel beds into one model.
  
  
  CONCLUSIONS
  Larger volumes of epicardial fat are associated with larger amounts of coronary and extracranial carotid artery atherosclerosis in males, independent of cardiovascular risk factors. This could imply that epicardial fat also exerts a systemic effect on atherosclerosis development. Future longitudinal research is warranted to further disentangle these relationships with a specific focus on sex differences.
authors.affiliation: Department of Radiology, Erasmus MC, PO Box 2040, Rotterdam 3000CA, The Netherlands Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Daniel
authors.initials: D
authors.lastname: Bos
authors.affiliation: Division of Image Processing, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Rahil
authors.initials: R
authors.lastname: Shahzad
authors.affiliation: Biomedical Imaging Group Rotterdam, Departments of Medical Informatics and Radiology, Erasmus MC, Rotterdam, the Netherlands.
authors.forename: Theo
authors.initials: T
authors.lastname: van Walsum
authors.affiliation: Quantitative imaging group, Faculty of Applied Sciences, Delft University of Technology, Delft, the Netherlands.
authors.forename: Lucas J
authors.initials: LJ
authors.lastname: van Vliet
authors.affiliation: Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Oscar H
authors.initials: OH
authors.lastname: Franco
authors.affiliation: Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Albert
authors.initials: A
authors.lastname: Hofman
authors.affiliation: Biomedical Imaging Group Rotterdam, Departments of Medical Informatics and Radiology, Erasmus MC, Rotterdam, the Netherlands Quantitative imaging group, Faculty of Applied Sciences, Delft University of Technology, Delft, the Netherlands.
authors.forename: Wiro J
authors.initials: WJ
authors.lastname: Niessen
authors.affiliation: Department of Radiology, Erasmus MC, PO Box 2040, Rotterdam 3000CA, The Netherlands Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Meike W
authors.initials: MW
authors.lastname: Vernooij
authors.affiliation: Department of Radiology, Erasmus MC, PO Box 2040, Rotterdam 3000CA, The Netherlands a.vanderlugt@erasmusmc.nl.
authors.forename: Aad
authors.initials: A
authors.lastname: van der Lugt
mesh_terms: D000273:Adipose Tissue / Q000000981:diagnostic imaging / Q000473:pathology*; D000368:Aged; D050197:Atherosclerosis / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010496:Pericardium / Q000000981:diagnostic imaging / Q000473:pathology*; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D061205:Vascular Calcification / Q000000981:diagnostic imaging / Q000473:pathology*
keywords: CT; atherosclerosis; epicardial fat; epidemiology; imaging