Pericardial fat, visceral abdominal fat, cardiovascular disease risk factors, and vascular calcification in a community-based sample - The framingham heart study
Pericardial fat, visceral abdominal fat, cardiovascular disease risk factors, and vascular calcification in a community-based sample - The framingham heart study
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DOI：
10.1161/circulationaha.107.743062
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发表时间：
2008-02-05
期刊：
影响因子：
37.8
通讯作者：
Fox, Caroline S.
中科院分区：
文献类型：
--
作者：
Rosito, Guido A.;Massaro, Joseph M.;Fox, Caroline S.
背景-心包脂肪可能是代谢风险的重要介质。在基于社区的样本中，缺乏与心血管疾病危险因素和血管钙化的相关性。我们试图研究心包脂肪、代谢危险因素和血管钙化之间的关系。方法和结果--来自心脏病研究的无心血管疾病的受试者（n = 1155，平均年龄63岁，54.8%为女性），他们是多探测器计算机断层扫描研究的一部分，接受了胸内脂肪、心包脂肪、内脏腹部脂肪（VAT）的定量，冠状动脉钙化和主动脉钙化。检查胸内和心包脂肪体积与体重指数、腰围、VAT、代谢危险因素、冠状动脉钙化和腹主动脉钙化的关系。胸内和心包脂肪与体重指数（r = 0.41 ~ 0.51，P = 0.001）、腰围（r = 0.43 ~ 0.53，P < 0.001）和增值税（r = 0.62 ~ 0.76，P < 0.001）直接相关。胸内和心包脂肪都与较高的甘油三酯有关（P < 0.0001），降低高密度脂蛋白（P < 0.0001），高血压空腹血糖受损（P < 0.0001 ~ 0.01）经多变量校正后，糖尿病（P = 0.0005 ~ 0.009）和代谢综合征（P < 0.0001）。在对体重指数和腰围进行额外调整后，相关性普遍持续存在，但在对VAT进行调整后，相关性则不存在（均P > 0.05）。在多变量和VAT校正后，心包脂肪与冠状动脉钙化相关，而胸内脂肪与冠状动脉钙化无关（比值比1.21，95%置信区间1.005 - 1.46，P = 0.04），而胸内脂肪，而不是心包脂肪，与腹主动脉钙化相关（比值比1.32，95%可信区间1.03 ~ 1.67，P = 0.03）结论-心包脂肪与肥胖和心血管疾病危险因素的多种测量相关，但VAT与大多数代谢危险因素的相关性更强。然而，胸内和心包脂肪与血管钙化有关，这表明这些脂肪库可能对血管系统产生局部毒性作用。
Background - Pericardial fat may be an important mediator of metabolic risk. Correlations with cardiovascular disease risk factors and vascular calcification in a community-based sample are lacking. We sought to examine associations between pericardial fat, metabolic risk factors, and vascular calcification.Methods and Results - Participants free of cardiovascular disease from the Framingham Heart Study (n = 1155, mean age 63 years, 54.8% women) who were part of a multidetector computed tomography study underwent quantification of intrathoracic fat, pericardial fat, visceral abdominal fat (VAT), coronary artery calcification, and aortic artery calcification. Intrathoracic and pericardial fat volumes were examined in relation to body mass index, waist circumference, VAT, metabolic risk factors, coronary artery calcification, and abdominal aortic calcification. Intrathoracic and pericardial fat were directly correlated with body mass index (r = 0.41 to 0.51, P = 0.001), waist circumference (r = 0.43 to 0.53, P < 0.001), and VAT (r = 0.62 to 0.76, P < 0.001). Both intrathoracic and pericardial fat were associated with higher triglycerides (P < 0.0001), lower high-density lipoprotein (P < 0.0001), hypertension (P < 0.0001 to 0.01), impaired fasting glucose (P < 0.0001 to 0.001), diabetes mellitus (P = 0.0005 to 0.009), and metabolic syndrome (P < 0.0001) after multivariable adjustment. Associations generally persisted after additional adjustment for body mass index and waist circumference but not after adjustment for VAT (all P > 0.05). Pericardial fat, but not intrathoracic fat, was associated with coronary artery calcification after multivariable and VAT adjustment (odds ratio 1.21, 95% confidence interval 1.005 to 1.46, P = 0.04), whereas intrathoracic fat, but not pericardial fat, was associated with abdominal aortic calcification (odds ratio 1.32, 95% confidence interval 1.03 to 1.67, P = 0.03).Conclusions - Pericardial fat is correlated with multiple measures of adiposity and cardiovascular disease risk factors, but VAT is a stronger correlate of most metabolic risk factors. However, intrathoracic and pericardial fat are associated with vascular calcification, which suggests that these fat depots may exert local toxic effects on the vasculature.