title: Epicardial Adipose Tissue (EAT) Thickness Is Associated with Cardiovascular and Liver Damage in Nonalcoholic Fatty Liver Disease.
abstract: OBJECTIVE
  Epicardial adipose tissue (EAT) has been proposed as a cardiometabolic and hepatic fibrosis risk factor in patients with non alcoholic fatty liver disease (NAFLD). Aim of this study was to evaluate the role of EAT in NAFLD by analyzing 1) the association between EAT, the other metabolic parameters and the severity of steatosis 2) the relationship between cardiovascular (cIMT, cplaques, E/A), liver (presence of NASH and significant fibrosis) damage and metabolic risk factors including EAT 3) the relationship between EAT and genetic factors strongly influencing liver steatosis.
  
  
  METHODS
  In a cross-sectional study, we considered 512 consecutive patients with NAFLD (confirmed by biopsy in 100). EAT, severity of steatosis, carotid intima-media thickness (cIMT) and plaques were evaluated by ultrasonography and results analysed by multiple linear and logistic regression models. Variables independently associated with EAT (mm) were female gender (p = 0.003), age (p = 0.001), BMI (p = 0.01), diastolic blood pressure (p = 0.009), steatosis grade 2 (p = 0.01) and 3 (p = 0.04), fatty liver index (p = 0.001) and statin use (p = 0.03). Variables independently associated with carotid IMT were age (p = 0.0001), hypertension (p = 0.009), diabetes (p = 0.04), smoking habits (p = 0.04) and fatty liver index (p = 0.02), with carotid plaques age (p = 0.0001), BMI (p = 0.03), EAT (p = 0.02),) and hypertension (p = 0.02), and with E/A age (p = 0.0001), diabetes (p = 0.005), hypertension (p = 0.04) and fatty liver index (p = 0.004). In the 100 patients with available liver histology non alcoholic steatohepatitis (NASH) was independently associated with EAT (p = 0.04) and diabetes (p = 0.054) while significant fibrosis with EAT (p = 0.02), diabetes (p = 0.01) and waist circumference (p = 0.05). No association between EAT and PNPLA3 and TM6SF2 polymorphisms was found.
  
  
  CONCLUSIONS
  In patients with NAFLD, EAT is associated with the severity of liver and vascular damage besides with the known metabolic risk factors.
authors.affiliation: Department of Pathophysiology and Transplantation, Ca' Granda Foundation IRCCS Maggiore Policlinico Hospital, University of Milan, Milan, Italy.
authors.forename: Anna Ludovica
authors.identifier: http://orcid.org/0000-0001-5918-0171
authors.initials: AL
authors.lastname: Fracanzani
authors.affiliation: Department of Pathophysiology and Transplantation, Ca' Granda Foundation IRCCS Maggiore Policlinico Hospital, University of Milan, Milan, Italy.
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Pisano
authors.affiliation: Epidemiology Unit, Ca' Granda Foundation IRCCS Maggiore Policlinico Hospital, University of Milan, Milan, Italy.
authors.forename: Dario
authors.initials: D
authors.lastname: Consonni
authors.affiliation: Department of Pathophysiology and Transplantation, Ca' Granda Foundation IRCCS Maggiore Policlinico Hospital, University of Milan, Milan, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Tiraboschi
authors.affiliation: Department of Pharmacological and Biomolecular Sciences, University of Milan and Centro Studi Aterosclerosi Milan, Milan, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Baragetti
authors.affiliation: Department of Pathophysiology and Transplantation, Ca' Granda Foundation IRCCS Maggiore Policlinico Hospital, University of Milan, Milan, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Bertelli
authors.affiliation: Department of Pharmacological and Biomolecular Sciences, University of Milan and Centro Studi Aterosclerosi Milan, Milan, Italy.
authors.forename: Giuseppe Danilo
authors.initials: GD
authors.lastname: Norata
authors.affiliation: Department of Pathophysiology and Transplantation, Ca' Granda Foundation IRCCS Maggiore Policlinico Hospital, University of Milan, Milan, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Dongiovanni
authors.affiliation: Department of Pathophysiology and Transplantation, Ca' Granda Foundation IRCCS Maggiore Policlinico Hospital, University of Milan, Milan, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Valenti
authors.affiliation: Centro Studi Aterosclerosi, Bassini Hospital, Milan, Italy.
authors.forename: Liliana
authors.initials: L
authors.lastname: Grigore
authors.affiliation: Cardiovascular Medicine Unit, Ca' Granda Foundation IRCCS Maggiore Policlinico Hospital, Milan, Italy.
authors.forename: Tatiana
authors.initials: T
authors.lastname: Tonella
authors.affiliation: Department of Pharmacological and Biomolecular Sciences, University of Milano, and Multimedica IRCCS, Milan, Italy.
authors.forename: Alberico
authors.initials: A
authors.lastname: Catapano
authors.affiliation: Department of Pathophysiology and Transplantation, Ca' Granda Foundation IRCCS Maggiore Policlinico Hospital, University of Milan, Milan, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Fargion
mesh_terms: D000273:Adipose Tissue / Q000473:pathology*; D000368:Aged; D002318:Cardiovascular Diseases / Q000473:pathology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008099:Liver / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000473:pathology*; D010496:Pericardium / Q000473:pathology*