Sage Journals: Discover world-class research

Abstract

Background

Recent studies suggest that pericardial adipose tissue (PAT) is associated with whole body adiposity and insulin resistance. Moreover, the incidence of cardiovascular disease (CVD) differs between men and women. Although CVD is more prevalent in men, women suffering from CVD have a higher mortality compared to men. Differences in PAT may account for some of the observed sex differences in manifestations of CVD.

Purpose

To assess pericardial adipose tissue (PAT) as a biomarker for cardiometabolic risk and to assess potential sex differences.

Material and Methods

We studied 303 individuals (151 women, 152 men; mean age = 57 ± 17 years) across the weight spectrum. PAT and abdominal adipose tissue were quantified using clinical computed tomography (CT) scans obtained as part of a positron emission tomography (PET)/CT. Cardiometabolic risk factors were assessed from medical records. Linear regression and receiver operating characteristic (ROC) curve analyses were performed to evaluate associations between PAT and cardiometabolic risk.

Results

PAT was higher in overweight and obese individuals compared to lean individuals and higher in men compared to women. PAT was positively associated with body mass index, abdominal fat (P < 0.0001), fasting glucose, and serum lipids (P < 0.05) with stronger associations in women than in men. PAT was accurate in detecting the prevalence of the metabolic syndrome with 74% sensitivity and 76% specificity (AUC = 0.80).

Conclusion

PAT is associated with measures of cardiometabolic risk and these associations are stronger in women compared to men. PAT could serve as a biomarker for opportunistic screening for cardiometabolic risk in patients undergoing chest CT.

Keywords

Pericardial adipose tissue computed tomography cardiometabolic risk metabolic syndrome opportunistic screening obesity biomarker

Get full access to this article

View all access options for this article.

References

Friedman

Wang

Meigs

et al.

Pericardial fat is associated with atrial conduction: the Framingham Heart Study. J Am Heart Assoc 2014; 3: e000477–e000477.

Baker

Silva

Quinn

et al.

Human epicardial adipose tissue expresses a pathogenic profile of adipocytokines in patients with cardiovascular disease. Cardiovasc Diabetol 2006; 5: 1–1.

Cheng

Chu

Lee

et al.

Adipocytokines and proinflammatory mediators from abdominal and epicardial adipose tissue in patients with coronary artery disease. Int J Obes (Lond) 2008; 32: 268–274.

Fantuzzi

Mazzone

. Adipose tissue and atherosclerosis: exploring the connection. Arterioscler Thromb Vasc Biol 2007; 27: 996–1003.

Yudkin

Eringa

Stehouwer

. “Vasocrine” signalling from perivascular fat: a mechanism linking insulin resistance to vascular disease. Lancet 2005; 365: 181718–1820.

Arnold

Psaty

Kuller

et al.

Incidence of cardiovascular disease in older Americans: the cardiovascular health study. J Am Geriatr Soc 2005; 53: 211–218.

Ding

Kritchevsky

Hsu

et al.

Association between non-subcutaneous adiposity and calcified coronary plaque: a substudy of the Multi-Ethnic Study of Atherosclerosis. Am J Clin Nutr 2008; 88: 645–650.

Godoy

Martinez-Salazar

Eajazi

et al.

Fat accumulation in the tongue is associated with male gender, abnormal upper airway patency and whole-body adiposity. Metabolism 2016; 65: 1657–1663.

Torriani

Gill

Daley

et al.

Compartmental neck fat accumulation and its relation to cardiovascular risk and metabolic syndrome. Am J Clin Nutr 2014; 100: 1244–1251.

10.

Chung

Kwon

Song

et al.

Epicardial adipose tissue: relationship between measurement location and metabolic syndrome. Int J Cardiovasc Imaging 2014; 30: 195–204.

11.

Borkan

Gerzof

Robbins

et al.

Assessment of abdominal fat content by computed tomography. Am J Clin Nutr 1982; 36: 172–177.

12.

Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA 2001; 285: 2486–2497.

13.

Brinkley

Hsu

Carr

et al.

Pericardial fat is associated with carotid stiffness in the Multi-Ethnic Study of Atherosclerosis. Nutr Metab Cardiovasc Dis 2011; 21: 332–338.

14.

Lee

Yin

Hoffmann

et al.

Relation of pericardial fat, intrathoracic fat, and abdominal visceral fat with incident atrial fibrillation (from the Framingham Heart Study). Am J Cardiol 2016; 118: 1486–1492.

15.

Rosito

Massaro

Hoffmann

et al.

Pericardial fat, visceral abdominal fat, cardiovascular disease risk factors, and vascular calcification in a community-based sample: the Framingham Heart Study. Circulation 2008; 117: 605–613.

16.

Schlett

Ferencik

Kriegel

et al.

Association of pericardial fat and coronary high-risk lesions as determined by cardiac CT. Atherosclerosis 2012; 222: 129–134.

17.

Soliman

Ding

Hsu

et al.

Association between carotid intima-media thickness and pericardial fat in the Multi-Ethnic Study of Atherosclerosis (MESA). J Stroke Cerebrovasc Dis 2010; 19: 58–65.

18.

Gulati

Cooper-DeHoff

McClure

et al.

Adverse cardiovascular outcomes in women with nonobstructive coronary artery disease: a report from the Women’s Ischemia Syndrome Evaluation Study and the St James Women Take Heart Project. Arch Intern Med 2009; 169: 843–850.

19.

Shaw

Bugiardini

Merz

. Women and ischemic heart disease: evolving knowledge. J Am Coll Cardiol 2009; 54: 1561–1575.

20.

Camhi

Bray

Bouchard

et al.

The relationship of waist circumference and BMI to visceral, subcutaneous, and total body fat: sex and race differences. Obesity (Silver Spring) 2011; 19: 402–408.

21.

Ibrahim

. Subcutaneous and visceral adipose tissue: structural and functional differences. Obes Rev 2010; 11: 11–18.

22.

Kim

Shim

et al.

Epicardial adipose tissue is related to cardiac function in elderly women, but not in men. Nutr Metab Cardiovasc Dis 2017; 27: 41–47.

23.

El Khoudary

Shields

Janssen

et al.

Cardiovascular fat, menopause, and sex hormones in women: The SWAN Cardiovascular Fat Ancillary Study. J Clin Endocrinol Metab 2015; 100: 3304–3312.

24.

Kocher

Christiansen

Martin

et al.

Sexual dimorphism in obesity-related genes in the epicardial fat during aging. J Physiol Biochem 2017; 73: 215–224.

25.

Buckens

Dijkhuis

de Keizer

et al.

Opportunistic screening for osteoporosis on routine computed tomography? An external validation study. Eur Radiol 2015; 25: 2074–2079.

26.

Buckens

van der Graaf

Verkooijen

et al.

Osteoporosis markers on low-dose lung cancer screening chest computed tomography scans predict all-cause mortality. Eur Radiol 2015; 25: 132–139.

27.

Garner

Paturzo

Gaudier

et al.

Variation in attenuation in L1 trabecular bone at different tube voltages: caution is warranted when screening for osteoporosis with the use of opportunistic CT. AJR Am J Roentgenol 2017; 208: 165–170.

28.

Lee

Anderson

Pickhardt

. Predicting future hip fractures on routine abdominal CT using opportunistic osteoporosis screening measures: a matched case-control study. AJR Am J Roentgenol 2017; 209: 395–402.

29.

Pickhardt

Pooler

Lauder

et al.

Opportunistic screening for osteoporosis using abdominal computed tomography scans obtained for other indications. Ann Intern Med 2013; 158: 588–595.

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

0.04 MB

Sex differences in pericardial adipose tissue assessed by PET/CT and association with cardiometabolic risk

Abstract

Background

Purpose

Material and Methods

Results

Conclusion

Keywords

Get full access to this article

References

Supplementary Material