title: Subclinical atherosclerosis is associated with Epicardial Fat Thickness and hepatic steatosis in the general population.
abstract: OBJECTIVE
  Abdominal obesity and hepatic steatosis are ectopic fat depots associated with Metabolic Syndrome (MetS). Epicardial Fat Thickness (EFT) is a newly discovered one, increasing with obesity, insulin resistance and MetS. Therefore we studied whether different ectopic fat markers, and EFT in particular, are associated with MetS and markers of subclinical cardiovascular disease.
  
  
  RESULTS
  868 subjects from the PLIC Study were included, EFT, aortic calcifications, carotid Intima-Media Thickness (c-IMT) and echocardiographic parameters were determined by ultrasound; extra-cardiac atherosclerotic lesions were defined in presence of plaques at both carotid and aortic levels. Hepatic steatosis degrees were defined according to a scoring system. Abdominal adiposity was determined using Dual X-ray Absorbimetry (DEXA). Independently from age, women showed higher EFT versus men (4.5 (0.20-9.00) mm vs 4.00 (0.10-8.00) mm, p = 0.013); EFT was thicker in post-menopausal women (independently from hormone-replacement therapy). EFT, liver steatosis and abdominal adiposity increased with MetS (p < 0.001). EFT was the only ectopic fat marker associated with cardiac dysfunction (OR = 1.340 [1.088-1.651 95% C.I., p = 0.006); liver steatosis and EFT were associated with extra-cardiac plaques (OR = 2.529 [1.328-4.819] 95% C.I., p < 0.001 and OR = 1.195 [1.008-1.299] 95% C.I., p = 0.042; respectively). On top of cardiovascular risk factors, only EFT improved the discrimination of subjects with cardiac dysfunction and atherosclerotic plaques.
  
  
  CONCLUSIONS
  EFT is associated with left ventricular dysfunction and subclinical atherosclerosis. Our data suggest that EFT may represent an additional tool for the stratification of cardiovascular risk.
authors.affiliation: Center for the Study of Atherosclerosis, Bassini Hospital, Cinisello Balsamo, Milan, Italy; Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Milan, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Baragetti
authors.affiliation: Dipartimento di Medicina Interna, Centro Studi Malattie Metaboliche del Fegato - Cà Granda IRCCS Fondazione Ospedale Policlinico, Milan, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Pisano
authors.affiliation: Dipartimento di Medicina Interna, Centro Studi Malattie Metaboliche del Fegato - Cà Granda IRCCS Fondazione Ospedale Policlinico, Milan, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Bertelli
authors.affiliation: Center for the Study of Atherosclerosis, Bassini Hospital, Cinisello Balsamo, Milan, Italy.
authors.forename: K
authors.initials: K
authors.lastname: Garlaschelli
authors.affiliation: Center for the Study of Atherosclerosis, Bassini Hospital, Cinisello Balsamo, Milan, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Grigore
authors.affiliation: Dipartimento di Medicina Interna, Centro Studi Malattie Metaboliche del Fegato - Cà Granda IRCCS Fondazione Ospedale Policlinico, Milan, Italy.
authors.forename: A L
authors.initials: AL
authors.lastname: Fracanzani
authors.affiliation: Dipartimento di Medicina Interna, Centro Studi Malattie Metaboliche del Fegato - Cà Granda IRCCS Fondazione Ospedale Policlinico, Milan, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Fargion
authors.affiliation: Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Milan, Italy; William Harvey Research Institute, Barts and The London School of Medicine & Dentistry Queen's Mary University, London, United Kingdom. Electronic address: danilo.norata@unimi.it.
authors.forename: G D
authors.initials: GD
authors.lastname: Norata
authors.affiliation: Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Milan, Italy; Multimedica Hospital - IRCCS, Sesto San Giovanni, Milan, Italy. Electronic address: alberico.catapano@unimi.it.
authors.forename: A L
authors.initials: AL
authors.lastname: Catapano
mesh_terms: D015502:Absorptiometry, Photon; D000273:Adipose Tissue; D050154:Adiposity; D000368:Aged; D001018:Aortic Diseases / Q000150:complications* / Q000000981:diagnostic imaging; D058070:Asymptomatic Diseases; D050197:Atherosclerosis / Q000000981:diagnostic imaging / Q000209:etiology*; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D059168:Carotid Intima-Media Thickness; D016009:Chi-Square Distribution; D018618:Echocardiography, Doppler, Color; D005234:Fatty Liver / Q000150:complications* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications* / Q000175:diagnosis; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000150:complications* / Q000175:diagnosis; D016017:Odds Ratio; D010496:Pericardium; D058226:Plaque, Atherosclerotic; D011237:Predictive Value of Tests; D012307:Risk Factors; D012737:Sex Factors; D061205:Vascular Calcification / Q000000981:diagnostic imaging / Q000209:etiology*; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000209:etiology
keywords: Cardiovascular; Epicardial fat; Steatosis