Epicardial Adipose Tissue in the General Middle-aged Population and Its Association With Metabolic Syndrome

Rev Esp Cardiol (Engl Ed). 2017 Apr;70(4):254-260. doi: 10.1016/j.rec.2016.08.001. Epub 2016 Nov 23.
[Article in English, Spanish]

Abstract

Introduction and objectives: 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.

Keywords: Ecocardiografía transtorácica; Epicardial fat; Estudio RIVANA; General population; Grasa epicárdica; Metabolic syndrome; Población general; RIVANA Study; Síndrome metabólico; Transthoracic echocardiography.

MeSH terms

  • Adipose Tissue / physiology*
  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers / metabolism
  • Blood Glucose / metabolism
  • C-Reactive Protein / metabolism
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / etiology
  • Cholesterol, HDL / metabolism
  • Female
  • Humans
  • Male
  • Metabolic Syndrome / ethnology
  • Metabolic Syndrome / etiology*
  • Middle Aged
  • Pericardium
  • Physical Examination
  • Risk Factors
  • Spain / epidemiology
  • Triglycerides / metabolism

Substances

  • Biomarkers
  • Blood Glucose
  • Cholesterol, HDL
  • Triglycerides
  • C-Reactive Protein