title: Epicardial Adipose Tissue in the General Middle-aged Population and Its Association With Metabolic Syndrome.
abstract: OBJECTIVE
  There is currently increasing interest in epicardial adipose tissue (EAT) as a marker of cardiovascular disease. Our purpose was to describe EAT, measured by transthoracic echocardiography, and to assess its association with metabolic syndrome (MS) in the RIVANA population-based study.
  
  
  METHODS
  Physical examination was performed in 880 participants aged 45 to 74 years (492 of them with MS according to the harmonized definition). Fasting glucose, high-density lipoprotein cholesterol, triglyceride, and C-reactive protein concentrations were determined in a blood sample. In all participants, EAT thickness was measured with transthoracic echocardiography at end-systole.
  
  
  RESULTS
  Among participants without MS, the prevalence of EAT ≥ 5mm significantly increased with age (OR > 65 years vs 45-54 years=8.22; 95%CI, 3.90-17.35; P for trend<.001). Increasing EAT quintiles were significantly associated with MS (OR fifth quintile vs first quintile=3.26; 95%CI, 1.59-6.71; P for trend=.001). Considering the different MS criteria, increasing quintiles of EAT were independently associated with low high-density lipoprotein cholesterol (OR fifth quintile vs first quintile=2.65; 95%CI, 1.16-6.05; P for trend=.028), high triglycerides (OR fifth quintile vs first quintile=2.22; 95%CI, 1.26-3.90; P for trend=.003), and elevated waist circumference (OR fifth quintile vs first quintile=6.85; 95%CI, 2.91-16.11; P for trend<.001).
  
  
  CONCLUSIONS
  In a subsample of the general population, EAT measured by echocardiography increased significantly and independently with age. Increased EAT thickness was independently associated with MS and with low high-density lipoprotein cholesterol, high triglycerides, and elevated waist circumference as individual criteria.
authors.affiliation: Departamento de Cardiología y Cirugía Cardiovascular, Clínica Universidad de Navarra, Universidad de Navarra, Pamplona, Navarra, Spain. Electronic address: alvaro.calago@gmail.com.
authors.forename: Álvaro
authors.initials: Á
authors.lastname: Calabuig
authors.affiliation: Departamento de Cardiología y Cirugía Cardiovascular, Clínica Universidad de Navarra, Universidad de Navarra, Pamplona, Navarra, Spain; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Navarra, Spain.
authors.forename: Joaquín
authors.initials: J
authors.lastname: Barba
authors.affiliation: Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Navarra, Spain; Servicio de Planificación, Evaluación y Gestión del Conocimiento, Sección de Formación, Departamento de Salud, Gobierno de Navarra, Pamplona, Navarra, Spain.
authors.forename: María Jesús
authors.initials: MJ
authors.lastname: Guembe
authors.affiliation: Departamento de Cardiología y Cirugía Cardiovascular, Clínica Universidad de Navarra, Universidad de Navarra, Pamplona, Navarra, Spain; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Navarra, Spain; Programa de Enfermedades Cardiovasculares, Centro de Investigación Médica Aplicada, Universidad de Navarra, Pamplona, Navarra, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Díez
authors.affiliation: Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Navarra, Spain; Servicio de Cardiología, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain.
authors.forename: Jesús
authors.initials: J
authors.lastname: Berjón
authors.affiliation: Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Navarra, Spain; Departamento de Neurología, Clínica Universidad de Navarra, Universidad de Navarra, Pamplona, Navarra, Spain.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Martínez-Vila
authors.affiliation: Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Navarra, Spain; Departamento de Neurología, Clínica Universidad de Navarra, Universidad de Navarra, Pamplona, Navarra, Spain.
authors.forename: Pablo
authors.initials: P
authors.lastname: Irimia
authors.affiliation: Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Navarra, Spain; Departamento de Medicina Preventiva y Salud Pública, Universidad de Navarra, Pamplona, Navarra, Spain; Centro de Investigación Biomédica en Red (CIBER) - Fisiopatología de la Obesidad y Nutrición, Madrid, Spain.
authors.forename: Estefanía
authors.initials: E
authors.lastname: Toledo
mesh_terms: D000273:Adipose Tissue / Q000502:physiology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000378:metabolism; D001786:Blood Glucose / Q000378:metabolism; D002097:C-Reactive Protein / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology; D008076:Cholesterol, HDL / Q000378:metabolism; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000208:ethnology / Q000209:etiology*; D008875:Middle Aged; D010496:Pericardium; D010808:Physical Examination; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D014280:Triglycerides / Q000378:metabolism
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D008076:Cholesterol, HDL; D014280:Triglycerides; D002097:C-Reactive Protein
keywords: Ecocardiografía transtorácica; Epicardial fat; Estudio RIVANA; General population; Grasa epicárdica; Metabolic syndrome; Población general; RIVANA Study; Síndrome metabólico; Transthoracic echocardiography