title: Differential impacts of cardiac and abdominal ectopic fat deposits on cardiometabolic risk stratification.
abstract: BACKGROUND
  Previous studies have shown that excessive abdominal visceral adipose tissue (AVAT) and epicardial adipose tissue (EAT) are risk factors of cardiometabolic disease; we hypothesized there is differential contribution of abdominal and cardiac fat deposits to the cardiometabolic profiles.
  
  
  METHODS
  Two hundred eight consecutive subjects with clinical suspicion of coronary artery disease (CAD) who underwent cardiac and abdominal CT for Agatston score and abdominal visceral fat measurement were retrospectively analyzed. Regional thickness of EAT (EATth), total volume of EAT, total volume of paracardial adipose tissue (PAT) and total volume of AVAT from L2 to L5 level were measured. The relationships between abdominal and cardiac adipose tissue measurements, the number of components of metabolic syndrome, and the severity of Agatston score on a four ranking scale (0, 1-10,11-100, 101-400, >400) were investigated.
  
  
  RESULTS
  The amounts of AVAT, EAT, PAT and EATth-LAVG showed a significant linear trend with increasing number (0-5) of components in metabolic syndrome (AVAT, EAT and PAT P for trend <0.0001; EATth-LVAG P for trend <0.001). EATth at left atrioventricular groove (EATth-LAVG) showed significant linear trend with the severity of Agatston score on a four ranking scale (P for trend <0.0001). In multivariate binary regression analysis, total volume of AVAT was the sole adiposity predictor for metabolic syndrome independent to age, gender, and waist circumference (odds ratio of 1.20, 95 % CI 1.08-1.32, p < 0.001) while total volume of EAT, PAT, and EATth-LAVG were not. In contrary, EATth-LAVG was the sole adiposity predictor for Agatston score >400 (odds ratio of 1.11, 95% CI 1.034-1.184, p = 0.004).
  
  
  CONCLUSIONS
  Excessive total volume of AVAT appears to be preferentially associated with metabolic syndrome; while EAT, esp. EATth-LAVG is preferentially associated with coronary artery disease. This differential effect of the two adiposities deserves a large-scale cohort study for further investigation.
authors.affiliation: Department of Radiology, Kaohsiung Veterans General Hospital, No. 386, Ta-Chung 1st Road, Kaohsiung, 81362, Taiwan. fzwu@vghks.gov.tw.|Institute of Clinical Medicine, National Yang Ming University, Taipei, Taiwan. fzwu@vghks.gov.tw.
authors.forename: Fu-Zong
authors.initials: FZ
authors.lastname: Wu
authors.affiliation: Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, TX, USA. carolcwu@gmail.com.
authors.forename: Carol C
authors.initials: CC
authors.lastname: Wu
authors.affiliation: Department of Radiology, Kaohsiung Veterans General Hospital, No. 386, Ta-Chung 1st Road, Kaohsiung, 81362, Taiwan. intelligentperry@gmail.com.|Institute of Clinical Medicine, National Yang Ming University, Taipei, Taiwan. intelligentperry@gmail.com.
authors.forename: Pei-Lun
authors.initials: PL
authors.lastname: Kuo
authors.affiliation: Department of Radiology, Kaohsiung Veterans General Hospital, No. 386, Ta-Chung 1st Road, Kaohsiung, 81362, Taiwan. wu.mingting@gmail.com.|Institute of Clinical Medicine, National Yang Ming University, Taipei, Taiwan. wu.mingting@gmail.com.
authors.forename: Ming-Ting
authors.initials: MT
authors.lastname: Wu
mesh_terms: D000273:Adipose Tissue / Q000000981:diagnostic imaging; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000453:epidemiology; D008076:Cholesterol, HDL; D015331:Cohort Studies; D003331:Coronary Vessels / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging*; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology* / Q000378:metabolism; D008875:Middle Aged; D015999:Multivariate Analysis; D056128:Obesity, Abdominal / Q000453:epidemiology; D010496:Pericardium / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D014280:Triglycerides / Q000378:metabolism; D061205:Vascular Calcification / Q000000981:diagnostic imaging; D055105:Waist Circumference
chemical_list: D001786:Blood Glucose; D008076:Cholesterol, HDL; D014280:Triglycerides