Pericardial fat and subclinical and clinical measures of coronary heart disease

描述(由申请人提供)：我们建议调查心包脂肪与冠心病亚临床和临床措施的关系。在冠心病方面，内脏脂肪比皮下脂肪更有害。心包脂肪是心脏周围的一种新的脂肪储备，具有类似内脏脂肪的特性，由于冠状动脉的局部脂肪毒性和炎症，它可能特别有害。然而，缺乏流行病学证据。我们假设，心包脂肪的增加会加速冠状动脉的动脉粥样硬化过程，在通常评估的区域性脂肪储备中，心包脂肪是导致冠心病发展的主要因素。这项拟议的研究是动脉粥样硬化多种族研究(MESA)的辅助研究。我们将在6,814名年龄在45-84岁的白人、黑人、西班牙裔和亚裔美国人中，研究1)心包脂肪与亚临床冠心病(通过计算机断层扫描(CT)测量的钙化冠状动脉斑块)之间的关系，2)基线和心包脂肪变化与钙化冠状动脉斑块变化之间的关系，以及3)6,814名年龄在45-84岁的白人、黑人、西班牙裔和亚裔美国人中与心包脂肪相关的临床冠心病风险。钙化冠状动脉斑块和临床冠心病的测量将从现有的MESA数据库中获得。我们将在基线(N=6,814)和三年后的随访(N=6,000)时，使用MESA现有的CT扫描来测量心包脂肪的体积，钙化的冠状动脉斑块根据这些扫描进行量化。MESA队列对心血管疾病进行了广泛的纵向评估，是评估心包脂肪在冠心病发展中的作用的理想研究人群。多样化的研究人群还将提供关于要检查的关系的特定种族信息。更重要的是，现有的CT扫描使我们能够经济有效地测量心包脂肪，而不会给参与者带来额外的负担。美国国立卫生研究院肥胖研究特别工作组最近的报告指出，阐明不同脂肪库在肥胖相关疾病中的作用差异将进一步加深我们对肥胖及其健康后果之间联系的理解，这可能为治疗学提供新的靶点来破坏这种联系。鉴于冠心病对健康的影响，迫切需要检查心包脂肪和冠心病之间的关系。

DESCRIPTION (provided by applicant): We propose to investigate the association of pericardial fat with subclinical and clinical measures of coronary heart disease. Visceral fat is more detrimental than subcutaneous fat with regard to coronary heart disease. Pericardial fat, a novel fat depot around the heart with properties like visceral fat, may be especially detrimental due to local lipotoxicity and inflammation in coronary arteries. However, epidemiologic evidence is lacking. We hypothesize that increased amounts of pericardial fat accelerates the atherosclerotic process in coronary arteries and that pericardial fat is the primary contributor to the development of coronary heart disease among commonly assessed regional fat depots. The proposed study is an ancillary study to the Multi-Ethnic Study of Atherosclerosis (MESA). We will examine 1) the association of pericardial fat with subclinical coronary heart disease (calcified coronary plaque measured by computed tomography (CT)) at baseline, 2) the association of baseline and changes in pericardial fat with changes in calcified coronary plaque over three years, and 3) the risk of clinical coronary heart disease associated with pericardial fat in a 6 year follow-up among 6,814 white, black, Hispanic, and Asian American men and women, age 45-84. The measures of calcified coronary plaque and clinical coronary heart disease will be obtained from the existing MESA database. We will measure the volume of pericardial fat using the existing CT scans in MESA, from which calcified coronary plaque was quantified, at baseline (N=6,814) and a follow-up exam (N=6,000) three years later. The MESA cohort, with extensive longitudinal assessments of cardiovascular disease, is an ideal study population for assessing the role of pericardial fat in the development of coronary heart disease. The diversified study population will also provide ethnicity-specific information on the relationships to be examined. More importantly, the existing CT scans enable us to cost-effectively measure pericardial fat without extra burden to participants. The recent report of the NIH Obesity Research Task Force indicates that elucidation of differences in various fat depots with regard to their roles in obesity-associated diseases will further our understanding of the link between obesity and its health consequences, which may yield new targets for therapeutics to disrupt this link. Given the health impact of coronary heart disease, there is a pressing need to examine the relationship between pericardial fat and coronary heart disease.