The association of pericardial fat with incident coronary heart disease: the Multi-Ethnic Study of Atherosclerosis (MESA)
The association of pericardial fat with incident coronary heart disease: the Multi-Ethnic Study of Atherosclerosis (MESA)
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DOI：
10.3945/ajcn.2008.27358
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发表时间：
2009-09-01
影响因子：
7.1
通讯作者：
Carr, J. Jeffrey
中科院分区：
文献类型：
--
作者：
Ding, Jingzhong;Hsu, Fang-Chi;Carr, J. Jeffrey
背景资料：心包脂肪（即心脏周围的脂肪）可能通过局部释放炎症相关细胞因子在冠状动脉粥样硬化过程中发挥直接作用。横断面研究表明，心包脂肪与冠状动脉疾病正相关，与全身脂肪无关。目的：我们研究心包脂肪是否能预测未来的冠心病事件。设计：我们在998名个体中进行了一项病例队列研究，从6814名多种族动脉粥样硬化研究（梅萨）参与者和147名梅萨参与者中随机选择（998人中的26人）在2000年至2005年期间发生冠心病事件。心包脂肪的体积由心脏计算机断层扫描确定在baseline.Results：受试者的年龄范围为45-84岁（42%男性，45%白色，10%亚裔美国人，22%非洲裔美国人，23%西班牙裔）。心包脂肪与体重指数（相关系数= 0.45，P < 0.0001）和腰围（相关系数= 0.57，P < 0.0001）呈正相关。在未校正的分析中，心包脂肪（每1-SD增量的相对风险：1.33; 95% CI：1.15，1.54），而不是体重指数（1.00; 0.84，1.18），与冠心病的风险相关。腰围（1.14; 0.97，1.34; P = 0.1）与冠心病风险轻微相关。在进一步校正体重指数和其他心血管疾病危险因素后，心包脂肪与冠心病之间的关系仍然显著（1.26; 1.01，1.59）。结论：心包脂肪预测冠心病事件独立于传统的危险因素，包括体重指数。美国临床营养杂志2009;90：499-504。
Background: Pericardial fat (ie, fat around the heart) may have a direct role in the atherosclerotic process in coronary arteries through local release of inflammation-related cytokines. Cross-sectional studies suggest that pericardial fat is positively associated with coronary artery disease independent of total body fat.Objective: We investigated whether pericardial fat predicts future coronary heart disease events.Design: We conducted a case-cohort study in 998 individuals, who were randomly selected from 6814 Multi-Ethnic Study of Atherosclerosis (MESA) participants and 147 MESA participants (26 from those 998 individuals) who developed incident coronary heart disease from 2000 to 2005. The volume of pericardial fat was determined from cardiac computed tomography at baseline.Results: The age range of the subjects was 45-84 y (42% men, 45% white, 10% Asian American, 22% African American, and 23% Hispanic). Pericardial fat was positively correlated with both body mass index (correlation coefficient = 0.45, P < 0.0001) and waist circumference (correlation coefficient = 0.57, P < 0.0001). In un-adjusted analyses, pericardial fat (relative hazard per 1-SD increment: 1.33; 95% CI: 1.15, 1.54), but not body mass index (1.00; 0.84, 1.18), was associated with the risk of coronary heart disease. Waist circumference (1.14; 0.97, 1.34; P = 0.1) was marginally associated with the risk of coronary heart disease. The relation between pericardial fat and coronary heart disease remained significant after further adjustment for body mass index and other cardiovascular disease risk factors (1.26; 1.01, 1.59). The relation did not differ by sex.Conclusion: Pericardial fat predicts incident coronary heart disease independent of conventional risk factors, including body mass index. Am J Clin Nutr 2009;90:499-504.