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PLoS One. 2016 Sep 14;11(9):e0162473. doi: 10.1371/journal.pone.0162473. eCollection 2016.

Epicardial Adipose Tissue (EAT) Thickness Is Associated with Cardiovascular and Liver Damage in Nonalcoholic Fatty Liver Disease.

Author information

1
Department of Pathophysiology and Transplantation, Ca' Granda Foundation IRCCS Maggiore Policlinico Hospital, University of Milan, Milan, Italy.
2
Epidemiology Unit, Ca' Granda Foundation IRCCS Maggiore Policlinico Hospital, University of Milan, Milan, Italy.
3
Department of Pharmacological and Biomolecular Sciences, University of Milan and Centro Studi Aterosclerosi Milan, Milan, Italy.
4
Centro Studi Aterosclerosi, Bassini Hospital, Milan, Italy.
5
Cardiovascular Medicine Unit, Ca' Granda Foundation IRCCS Maggiore Policlinico Hospital, Milan, Italy.
6
Department of Pharmacological and Biomolecular Sciences, University of Milano, and Multimedica IRCCS, Milan, Italy.

Abstract

BACKGROUND AND AIMS:

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.

CONCLUSION:

In patients with NAFLD, EAT is associated with the severity of liver and vascular damage besides with the known metabolic risk factors.

PMID:
27627804
PMCID:
PMC5023162
DOI:
10.1371/journal.pone.0162473
[Indexed for MEDLINE]
Free PMC Article

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