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Ma ZY, Duan H, Han D, He B, Xie XJ, Lu L, Jiang J, Li RH. Epicardial fat in patients with metabolic syndrome: A systematic review and meta-analysis. Eur J Radiol 2023; 167:111056. [PMID: 37666076 DOI: 10.1016/j.ejrad.2023.111056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 08/14/2023] [Accepted: 08/21/2023] [Indexed: 09/06/2023]
Abstract
PURPOSE Abnormally increased epicardial fat appears to be associated with an additional risk of major adverse cardiovascular events (MACEs) in the context of metabolic syndrome (MetS). However, evidence on the relationship between epicardial fat volumes (EFVs), epicardial fat thickness (EFT) and MetS remains inconsistent. METHODS Specific searches of electronic databases from 1 January 2000 to 31 October 2022 were independently performed by two researchers. In this study, two quantification measures of epicardial fat were included: comparison of total computed tomography-based EFVs and EFT between two groups (individuals with and without MetS), estimating standardized mean difference (SMD) with corresponding 95 % confidence intervals (CIs) through a random-effects model analysis. The heterogeneity in the included studies was explored by meta-regression and subgroup analyses. RESULTS The EFVs were significantly increased in MetS subjects compared with non-MetS subjects (SMD: 1.07, 95 % CI: 0.69-1.45, p < 0.001), and the EFT was also significantly larger in MetS patients than in the Non-MetS (SMD: 1.12, 95 % CI: 0.84-1.41, p < 0.001). We compared the Caucasian and American subgroups with the Asian and African subgroups, and the EFT was greater in the former subgroups (SMD: 1.32, 95 % CI: 0.44-2.20, p < 0.001). When comparing the EFT among the age subgroups, there was a significant SMD between adolescents and adults or elderly individuals (SMD: 1.21, 95 % CI: 0.84-1.52, p < 0.001). CONCLUSIONS MetS patients tend to present greater EFT near the right ventricular free wall and greater total EFVs. Increased epicardial fat, an imaging biomarker, independently affects the onset of MetS.
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Affiliation(s)
- Zhong-Yan Ma
- Department of Radiology, The First Affiliated Hospital of Kunming Medical University, No. 295 Xichang road, Kunming 650032, China
| | - Hui Duan
- Department of Radiology, The First Affiliated Hospital of Kunming Medical University, No. 295 Xichang road, Kunming 650032, China.
| | - Dan Han
- Department of Radiology, The First Affiliated Hospital of Kunming Medical University, No. 295 Xichang road, Kunming 650032, China
| | - Bo He
- Department of Radiology, The First Affiliated Hospital of Kunming Medical University, No. 295 Xichang road, Kunming 650032, China
| | - Xiao-Jie Xie
- Department of Radiology, The First Affiliated Hospital of Kunming Medical University, No. 295 Xichang road, Kunming 650032, China
| | - Lin Lu
- Department of Radiology, The First Affiliated Hospital of Kunming Medical University, No. 295 Xichang road, Kunming 650032, China
| | - Jie Jiang
- Department of Radiology, The First Affiliated Hospital of Kunming Medical University, No. 295 Xichang road, Kunming 650032, China
| | - Rui-Hong Li
- Department of Radiology, The First Affiliated Hospital of Kunming Medical University, No. 295 Xichang road, Kunming 650032, China
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Shu L, Zhang J, Jia L, Wang J, Han Z. Effect of lipid accumulation product on the development of hypertension among nondiabetic individuals in eastern China: A cross-sectional study. J Clin Hypertens (Greenwich) 2023; 25:784-793. [PMID: 37433158 PMCID: PMC10423760 DOI: 10.1111/jch.14696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 06/13/2023] [Accepted: 06/25/2023] [Indexed: 07/13/2023]
Abstract
This study was aimed at assessing the risk factors for hypertension (HTN) and prehypertension (PHT) in order to clarify the role of lipid accumulation product (LAP) in the development of HTN among nondiabetic individuals. A large cross-sectional study was conducted in community health service centers in urban Bengbu, Anhui Province, China. All participants completed an interview questionnaire and procedures to obtain physical measurements and biochemical indicators. Multivariate logistic regression was used to test for the prevalence of HTN and PHT in relation to each quartile increase in LAP level and family history of HTN. The resulting interaction effects were evaluated by relative excess risk of interaction (RERI), attributable proportion due to interaction (AP), and synergy index (SI). A total of 7733 subjects were enrolled in the study. The overall prevalence rates of PHT and HTN were 37.1% and 24.8%, respectively. After adjusting for confounding factors, multinomial logistic regression analysis showed that compared with subjects in LAP quartile 1, those in quartile 3 (OR, 1.257; 95% CI, 1.062-1.494) and quartile 4 (OR, 1.323; 95% CI, 1.101-1.592) had a significantly higher risk for HTN (p for trend < .001). A significant interaction was observed between LAP and family history of HTN in men (AP, 0.1661; 95% CI, 0.0024-0.3296; SI, 1.4037; 95% CI, 1.0599-1.8593) and in women (RERI, 1.4111; 95% CI, 0.1458-2.9678; AP, 0.1662; 95% CI, 0.0085-0.3237; SI, 1.3886; 95% CI, 1.0568-1.8247). The results demonstrated that the interactive effects of LAP with family history of HTN may influence the development of HTN synergistically.
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Affiliation(s)
- Li Shu
- School of public healthBengbu medical collegeBengbuAnhuiChina
| | - Jiaye Zhang
- School of public healthBengbu medical collegeBengbuAnhuiChina
| | - Linlin Jia
- School of public healthBengbu medical collegeBengbuAnhuiChina
| | - Jinchen Wang
- School of public healthBengbu medical collegeBengbuAnhuiChina
| | - Ziyan Han
- School of public healthBengbu medical collegeBengbuAnhuiChina
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Liu J, Duan S, Wang C, Wang Y, Peng H, Niu Z, Yao S. Optimum non-invasive predictive indicators for metabolic dysfunction-associated fatty liver disease and its subgroups in the Chinese population: A retrospective case-control study. Front Endocrinol (Lausanne) 2022; 13:1035418. [PMID: 36531447 PMCID: PMC9751395 DOI: 10.3389/fendo.2022.1035418] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 11/15/2022] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVE Metabolic dysfunction-associated fatty liver disease (MAFLD) affects 25% of the population without approved drug therapy. According to the latest consensus, MAFLD is divided into three subgroups based on different diagnostic modalities, including Obesity, Lean, and Type 2 diabetes mellitus (T2DM) MAFLD subgroups. This study aimed to find out the optimum non-invasive metabolism-related indicators to respectively predict MAFLD and its subgroups. DESIGN 1058 Chinese participants were enrolled in this study. Anthropometric measurements, laboratory data, and ultrasonography features were collected. 22 metabolism-related indexes were calculated, including fatty liver index (FLI), lipid accumulation product (LAP), waist circumference-triglyceride index (WTI), etc. Logistic regression analyzed the correlation between indexes and MAFLD. Receiver operating characteristics were conducted to compare predictive values among 22 indicators for screening the best indicators to predict MAFLD in different subgroups. RESULTS FLI was the best predictor with the maximum odds ratio (OR) values of overall MAFLD (OR: 6.712, 95%CI: 4.766-9.452, area under the curve (AUC): 0.879, P < 0.05) and T2DM MAFLD subgroup (OR: 14.725, 95%CI: 3.712-58.420, AUC: 0.958, P < 0.05). LAP was the best predictor with the maximum OR value of Obesity MAFLD subgroup (OR: 2.689, 95%CI: 2.182-3.313, AUC: 0.796, P < 0.05). WTI was the best predictor with the maximum OR values of Lean MAFLD subgroup (OR: 3.512, 95%CI: 2.286-5.395, AUC: 0.920, P < 0.05). CONCLUSION The best predictors of overall MAFLD, Obesity, Lean, and T2DM MAFLD subgroups were respectively FLI, LAP, WTI, and FLI.
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Affiliation(s)
- Jing Liu
- Graduate School, Peking Union Medical College, Beijing, China
- Department of Gastroenterology, China-Japan Friendship Hospital, Beijing, China
| | - Shaojie Duan
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Che Wang
- School of Qi Huang, Beijing University of Chinese Medicine, Beijing, China
| | - Yutong Wang
- School of Qi Huang, Beijing University of Chinese Medicine, Beijing, China
| | - Hongye Peng
- Department of Infection, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Zuohu Niu
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Shukun Yao
- Department of Gastroenterology, China-Japan Friendship Hospital, Beijing, China
- *Correspondence: Shukun Yao,
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Giroud M, Jodeleit H, Prentice KJ, Bartelt A. Adipocyte function and the development of cardiometabolic disease. J Physiol 2021; 600:1189-1208. [PMID: 34555180 DOI: 10.1113/jp281979] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 08/31/2021] [Indexed: 11/08/2022] Open
Abstract
Obesity is a medical disorder caused by multiple mechanisms of dysregulated energy balance. A major consequence of obesity is an increased risk to develop diabetes, diabetic complications and cardiovascular disease. While a better understanding of the molecular mechanisms linking obesity, insulin resistance and cardiovascular disease is needed, translational research of the human pathology is hampered by the available cellular and rodent model systems. Major barriers are the species-specific differences in energy balance, vascular biology and adipose tissue physiology, especially related to white and brown adipocytes, and adipose tissue browning. In rodents, non-shivering thermogenesis is responsible for a large part of energy expenditure, but humans possess much less thermogenic fat, which means temperature is an important variable in translational research. Mouse models with predisposition to dyslipidaemia housed at thermoneutrality and fed a high-fat diet more closely reflect human physiology. Also, adipocytes play a key role in the endocrine regulation of cardiovascular function. Adipocytes secrete a variety of hormones, lipid mediators and other metabolites that directly influence the local microenvironment as well as distant tissues. This is specifically apparent in perivascular depots, where adipocytes modulate vascular function and inflammation. Altogether, these mechanisms highlight the critical role of adipocytes in the development of cardiometabolic disease.
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Affiliation(s)
- Maude Giroud
- Institute for Cardiovascular Prevention (IPEK), Ludwig-Maximilians-University, Munich, Germany.,Institute for Diabetes and Cancer (IDC), Helmholtz Center Munich, Neuherberg, Germany
| | - Henrika Jodeleit
- Institute for Cardiovascular Prevention (IPEK), Ludwig-Maximilians-University, Munich, Germany.,German Center for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, Bavaria, Germany
| | - Kacey J Prentice
- Department of Molecular Metabolism & Sabri Ülker Center for Metabolic Research, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Alexander Bartelt
- Institute for Cardiovascular Prevention (IPEK), Ludwig-Maximilians-University, Munich, Germany.,Institute for Diabetes and Cancer (IDC), Helmholtz Center Munich, Neuherberg, Germany.,German Center for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, Bavaria, Germany.,Department of Molecular Metabolism & Sabri Ülker Center for Metabolic Research, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Monti CB, Capra D, Malavazos A, Florini G, Parietti C, Schiaffino S, Sardanelli F, Secchi F. Subcutaneous, Paracardiac, and Epicardial Fat CT Density Before/After Contrast Injection: Any Correlation with CAD? J Clin Med 2021; 10:jcm10040735. [PMID: 33673256 PMCID: PMC7918165 DOI: 10.3390/jcm10040735] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 01/30/2021] [Accepted: 02/02/2021] [Indexed: 02/07/2023] Open
Abstract
Adipose tissue, in particular epicardial adipose tissue, has been identified as a potential biomarker of cardiovascular pathologies such as coronary artery disease (CAD) in the light of its metabolic activity and close anatomic and pathophysiologic relationship to the heart. Our purpose was to evaluate epicardial adipose tissue density at both unenhanced and contrast-enhanced computed tomography (CT), along with CT densities of paracardiac and subcutaneous adipose tissue, as well as the relations of such densities with CAD. We retrospectively reviewed patients who underwent cardiac CT at our institution for CAD assessment. We segmented regions of interest on epicardial, paracardiac, and subcutaneous adipose tissue on unenhanced and contrast-enhanced scans. A total of 480 patients were included, 164 of them presenting with CAD. Median epicardial adipose tissue density measured on contrast-enhanced scans (−81.5 HU; interquartile range −84.9 to −78.0) was higher than that measured on unenhanced scans (−73.4 HU; −76.9 to −69.4) (p < 0.001), whereas paracardiac and subcutaneous adipose tissue densities were not (p ≥ 0.055). Patients with or without CAD, did not show significant differences in density of epicardial, paracardiac, and subcutaneous adipose tissue either on unenhanced or contrast-enhanced scans (p ≥ 0.092). CAD patients may experience different phenomena (inflammation, fibrosis, increase in adipose depots) leading to rises or drops in epicardial adipose tissue density, resulting in variations that are difficult to detect.
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Affiliation(s)
- Caterina Beatrice Monti
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, 20133 Milano, Italy; (C.B.M.); (D.C.); (F.S.)
| | - Davide Capra
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, 20133 Milano, Italy; (C.B.M.); (D.C.); (F.S.)
| | - Alexis Malavazos
- Clinical Nutrition and Cardiovascular Prevention Unit and High Specialty Center for Dietetics, Nutritional Education and Cardiometabolic Prevention, IRCCS Policlinico San Donato, San Donato Milanese, 20097 Milano, Italy;
| | - Giorgia Florini
- School of Medicine and Surgery, Università degli Studi di Milano, 20122 Milano, Italy; (G.F.); (C.P.)
| | - Carlo Parietti
- School of Medicine and Surgery, Università degli Studi di Milano, 20122 Milano, Italy; (G.F.); (C.P.)
| | - Simone Schiaffino
- Department of Radiology, IRCCS Policlinico San Donato, San Donato Milanese, 20097 Milano, Italy;
| | - Francesco Sardanelli
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, 20133 Milano, Italy; (C.B.M.); (D.C.); (F.S.)
- Department of Radiology, IRCCS Policlinico San Donato, San Donato Milanese, 20097 Milano, Italy;
| | - Francesco Secchi
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, 20133 Milano, Italy; (C.B.M.); (D.C.); (F.S.)
- Department of Radiology, IRCCS Policlinico San Donato, San Donato Milanese, 20097 Milano, Italy;
- Correspondence:
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Chen MB, Wang H, Cui WY, Xu HL, Zheng QH. Effect of SGLT inhibitors on weight and lipid metabolism at 24 weeks of treatment in patients with diabetes mellitus: A systematic review and network meta-analysis. Medicine (Baltimore) 2021; 100:e24593. [PMID: 33578559 PMCID: PMC7886459 DOI: 10.1097/md.0000000000024593] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 01/14/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND The goals of improving quality of life and increasing longevity are receiving growing amounts of attention. Body weight and lipid metabolism are closely related to various complications of diabetes. The aim of this study was to rank SGLT inhibitors according to their efficacy with regard to weight and evaluate the effect of SGLT inhibitors on lipid metabolism at 24 weeks of treatment. METHODS The Web of Science, PubMed, Cochrane Library, Embase, and Clinical Trials databases were electronically searched to collect randomized controlled trials involving patients with type 2 diabetes mellitus through June 2020. Two researchers independently screened and evaluated the selected studies and extracted the outcome indexes. ADDIS 1.16.5 and STATA 16 software were used to perform the network meta-analysis and draw the plots. RESULTS Ultimately, 36 studies were selected and included in this study. We found that all SGLT inhibitors were effective at reducing weight; canagliflozin was the most effective. SGLT inhibitors and placebo were not associated with significantly different serum cholesterol levels. SGLT inhibitors lowered serum triglyceride levels and increased serum high-density and low-density lipoprotein cholesterol levels. SGLT inhibitors also reduced the level of alanine aminotransferase. CONCLUSIONS SGLT inhibitors can bring about weight loss in patients with T2DM and can also improve lipid metabolism. Therefore, patients with hyperlipidemia who have been unsuccessful at losing weight should consider taking SGLT inhibitors. In addition, SGLT inhibitors are hepatoprotective and appear to be safe for patients with mild to moderate liver dysfunction. TRIAL REGISTRATION CRD42020198516.
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Affiliation(s)
| | - Hua Wang
- Department of ICU, Wujin People's Hospital Affiliated with Jiangsu University and Wujin Clinical College of Xuzhou Medical University, Changzhou, Jiangsu, P.R. China
| | - Wei-yan Cui
- Department of ICU, Wujin People's Hospital Affiliated with Jiangsu University and Wujin Clinical College of Xuzhou Medical University, Changzhou, Jiangsu, P.R. China
| | - Hua-lan Xu
- Department of ICU, Wujin People's Hospital Affiliated with Jiangsu University and Wujin Clinical College of Xuzhou Medical University, Changzhou, Jiangsu, P.R. China
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González-Rivas JP, Mechanick JI, Iglesias-Fortes R, De-Oliveira-Gomes D, Silva J, Valencia J, Figueroa E, Duran M, Ugel E, Infante-García MM, Marulanda MI, Nieto-Martínez R. Optimal waist circumference cutoff values to predict cardiometabolic alterations in a Venezuela national representative sample. The EVESCAM study. ARCHIVOS DE CARDIOLOGIA DE MEXICO 2020; 91:272-280. [PMID: 33362194 PMCID: PMC8351653 DOI: 10.24875/acm.20000165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 08/20/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Waist circumference (WC) value reflects abdominal adiposity, but the amount abdominal fat that is associated to cardiometabolic risk factors varies among ethnicities. Determination of metabolic abnormalities has not undergone a WC adaptation process in Venezuela. AIMS The aim of the study was (1) to determine the optimal WC cutoff value associated with ≥2 cardiometabolic alterations and (2) incorporating this new WC cutoff, to determine the prevalence of abdominal obesity and cardiometabolic risk factors related in Venezuela. METHODS The study was national population-based, cross-sectional, and randomized sample, from 2014 to 2017. To assess performance of WC for identifying cardiometabolic alterations, receiver operating characteristics curves, area under the curve (AUC), sensitivity, specificity, and positive likelihood ratios were calculated. RESULTS Three thousand three hundred eighty-seven adults were evaluated with mean age of 41.2 ± 15.8 years. Using the best tradeoff between sensitivity and specificity, WC cutoffs of 90 cm in men (sensitivity = 72.4% and specificity = 66.1%) and 86 cm in women (sensitivity = 76.2% and specificity = 61.4%) were optimal for aggregation of ≥2 cardiometabolic alterations. AUC was 0.75 in men and 0.73 in women using these new cutoffs. Prevalence of abdominal obesity and metabolic syndrome was 59.6% (95 CI; 57.5-61.7) and 47.6% (95 CI; 45.2-50.0), respectively. Cardiometabolic risk factors were associated with being men, higher age, adiposity, and living in northern or western regions. CONCLUSION The optimal WC values associated with cardiometabolic alterations were 90 cm in men and 86 cm in women. More than half of the Venezuelan population had abdominal obesity incorporating this new WC cutoff.
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Affiliation(s)
- Juan P. González-Rivas
- International Clinical Research Center, St Anne’s University Hospital Brno, Brno, Czech Republic
- Department of Global Health and Population. Harvard TH Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
- Foundation for Clinic, Public Health, and Epidemiological Research of Venezuela (FISPEVEN), Caracas, Venezuela
| | - Jeffrey I. Mechanick
- Divisions of Cardiology and Endocrinology, Diabetes and Bone Disease, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Rocio Iglesias-Fortes
- Foundation for Clinic, Public Health, and Epidemiological Research of Venezuela (FISPEVEN), Caracas, Venezuela
| | - Diana De-Oliveira-Gomes
- Foundation for Clinic, Public Health, and Epidemiological Research of Venezuela (FISPEVEN), Caracas, Venezuela
| | - Jesús Silva
- Foundation for Clinic, Public Health, and Epidemiological Research of Venezuela (FISPEVEN), Caracas, Venezuela
| | - José Valencia
- Foundation for Clinic, Public Health, and Epidemiological Research of Venezuela (FISPEVEN), Caracas, Venezuela
| | - Estherbany Figueroa
- Foundation for Clinic, Public Health, and Epidemiological Research of Venezuela (FISPEVEN), Caracas, Venezuela
| | - Maritza Duran
- Foundation for Clinic, Public Health, and Epidemiological Research of Venezuela (FISPEVEN), Caracas, Venezuela
| | - Eunice Ugel
- Foundation for Clinic, Public Health, and Epidemiological Research of Venezuela (FISPEVEN), Caracas, Venezuela
- Department of Social and Preventive Medicine, Public Health Research Unit, School of Medicine, Universidad Centro-Occidental “Lisandro Alvarado”, Barquisimeto, Venezuela
| | - María M. Infante-García
- Foundation for Clinic, Public Health, and Epidemiological Research of Venezuela (FISPEVEN), Caracas, Venezuela
| | - María Inés Marulanda
- Foundation for Clinic, Public Health, and Epidemiological Research of Venezuela (FISPEVEN), Caracas, Venezuela
| | - Ramfis Nieto-Martínez
- Department of Global Health and Population. Harvard TH Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
- Foundation for Clinic, Public Health, and Epidemiological Research of Venezuela (FISPEVEN), Caracas, Venezuela
- LifeDoc Diabetes and Obesity Clinic, Memphis, TN, US
- Department of Physiology, School of Medicine, University Centro-Occidental “Lisandro Alvarado” and Cardio-metabolic Unit 7, Barquisimeto, Venezuela
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Mechanisms linking adipose tissue inflammation to cardiac hypertrophy and fibrosis. Clin Sci (Lond) 2020; 133:2329-2344. [PMID: 31777927 DOI: 10.1042/cs20190578] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 11/08/2019] [Accepted: 11/13/2019] [Indexed: 12/13/2022]
Abstract
Adipose tissue is classically recognized as the primary site of lipid storage, but in recent years has garnered appreciation for its broad role as an endocrine organ comprising multiple cell types whose collective secretome, termed as adipokines, is highly interdependent on metabolic homeostasis and inflammatory state. Anatomical location (e.g. visceral, subcutaneous, epicardial etc) and cellular composition of adipose tissue (e.g. white, beige, and brown adipocytes, macrophages etc.) also plays a critical role in determining its response to metabolic state, the resulting secretome, and its potential impact on remote tissues. Compared with other tissues, the heart has an extremely high and constant demand for energy generation, of which most is derived from oxidation of fatty acids. Availability of this fatty acid fuel source is dependent on adipose tissue, but evidence is mounting that adipose tissue plays a much broader role in cardiovascular physiology. In this review, we discuss the impact of the brown, subcutaneous, and visceral white, perivascular (PVAT), and epicardial adipose tissue (EAT) secretome on the development and progression of cardiovascular disease (CVD), with a particular focus on cardiac hypertrophy and fibrosis.
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Li Y, Liu X, Li G, Zhang P. Effect of liraglutide on epicardial adipose tissue thickness with echocardiography in patients with obese type 2 diabetes mellitus. Int J Diabetes Dev Ctries 2020. [DOI: 10.1007/s13410-020-00820-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
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Zong J, Sun Y, Zhang Y, Yuan J, Wang X, Zhang R, Zhao X, Zhao X, Gu Y. Correlation Between Serum Uric Acid Level and Central Body Fat Distribution in Patients with Type 2 Diabetes. Diabetes Metab Syndr Obes 2020; 13:2521-2531. [PMID: 32765031 PMCID: PMC7372004 DOI: 10.2147/dmso.s260891] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 06/25/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The aim of this study was to investigate the correlation between serum uric acid level and central body fat distribution in patients with type 2 diabetes (T2DM). METHODS A total of 867 patients with T2DM were enrolled. Measurements of central fat distribution were obtained by dual energy X-ray absorptiometry. Patients were stratified into three groups according to their levels of serum uric acid (SUA). Multiple linear regression analysis was used to determine the association between SUA and central body fat distribution. Logistic regression analysis was used to estimate the risk factors for hyperuricemia (HUA). Mediation analysis was applied to assess the overall, direct, and indirect mediators of SUA levels. RESULTS Multiple linear regression analysis showed that SUA levels were significantly positively correlated with waist circumference (WC), body mass index (BMI), visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), Android fat mass, Gynoid fat mass, fasting c-peptide (F-CP), and area under the curve of C-peptide (P < 0.05 for all). VAT [odds ratio (OR), 2.367; 95% confidence interval (CI), 1.078-5.197; P < 0.001)], WC (OR, 1.041; 95% CI, 1.011-1.072; P < 0.001), high-density lipoprotein (OR, 0.274; 95% CI, 0.104-0.727; P < 0.001), and estimated glomerular filtration rate (OR, 0.966; 95% CI, 0.959-0.973; P < 0.001) were found to be independent risk factors for T2DM patients with HUA. After mediation analysis, BMI and central obesity were found to have different partial effects on the association between SUA and F-CP (P < 0.001). CONCLUSION In patients with T2DM, HUA was positively correlated with F-CP and central body fat distribution, especially VAT. These results suggest that central obesity may play a role in the positive correlation between HUA and insulin resistance (IR).
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Affiliation(s)
- Jing Zong
- Department of Endocrinology and Metabolism, The Affiliated Hospital of Nantong University, Nantong, Jiangsu Province, People’s Republic of China
- Geriatric Department, Nantong First Geriatric Hospital, Nantong, Jiangsu Province, People’s Republic of China
| | - Yi Sun
- Department of Endocrinology and Metabolism, The Affiliated Hospital of Nantong University, Nantong, Jiangsu Province, People’s Republic of China
| | - Yiqian Zhang
- Department of Endocrinology and Metabolism, The Affiliated Hospital of Nantong University, Nantong, Jiangsu Province, People’s Republic of China
- Department of Endocrinology and Metabolism, Changshu No.1 People’s Hospital, Nantong, Jiangsu Province, People’s Republic of China
| | - Jin Yuan
- Department of Endocrinology and Metabolism, The Affiliated Hospital of Nantong University, Nantong, Jiangsu Province, People’s Republic of China
| | - Xinlei Wang
- Department of Endocrinology and Metabolism, The Affiliated Hospital of Nantong University, Nantong, Jiangsu Province, People’s Republic of China
| | - Rongping Zhang
- Department of Endocrinology and Metabolism, The Affiliated Hospital of Nantong University, Nantong, Jiangsu Province, People’s Republic of China
| | - Xiaoqin Zhao
- Department of Endocrinology and Metabolism, The Affiliated Hospital of Nantong University, Nantong, Jiangsu Province, People’s Republic of China
| | - Xuying Zhao
- Department of Endocrinology and Metabolism, The Affiliated Hospital of Nantong University, Nantong, Jiangsu Province, People’s Republic of China
| | - Yunjuan Gu
- Department of Endocrinology and Metabolism, The Affiliated Hospital of Nantong University, Nantong, Jiangsu Province, People’s Republic of China
- Correspondence: Yunjuan Gu Department of Endocrinology and Metabolism, The Affiliated Hospital of Nantong University, 20 Xisi Road, Nantong, Jiangsu Province, People’s Republic of ChinaTel +86 15851207860Fax +86-513-8116-1906 Email
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Lambert C, Arderiu G, Bejar MT, Crespo J, Baldellou M, Juan-Babot O, Badimon L. Stem cells from human cardiac adipose tissue depots show different gene expression and functional capacities. Stem Cell Res Ther 2019; 10:361. [PMID: 31783922 PMCID: PMC6884762 DOI: 10.1186/s13287-019-1460-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 10/16/2019] [Accepted: 10/17/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The composition and function of the adipose tissue covering the heart are poorly known. In this study, we have investigated the epicardial adipose tissue (EAT) covering the cardiac ventricular muscle and the EAT covering the left anterior descending artery (LAD) on the human heart, to identify their resident stem cell functional activity. METHODS EAT covering the cardiac ventricular muscle was isolated from the apex (avoiding areas irrigated by major vessels) of the heart (ventricular myocardium adipose tissue (VMAT)) and from the area covering the epicardial arterial sulcus of the LAD (PVAT) in human hearts excised during heart transplant surgery. Adipose stem cells (ASCs) from both adipose tissue depots were immediately isolated and phenotypically characterized by flow cytometry. The different behavior of these ASCs and their released secretome microvesicles (MVs) were investigated by molecular and cellular analysis. RESULTS ASCs from both VMAT (mASCs) and the PVAT (pASCs) were characterized by the expression of CD105, CD44, CD29, CD90, and CD73. The angiogenic-related genes VEGFA, COL18A1, and TF, as well as the miRNA126-3p and miRNA145-5p, were analyzed in both ASC types. Both ASCs were functionally able to form tube-like structures in three-dimensional basement membrane substrates. Interestingly, pASCs showed a higher level of expression of VEGFA and reduced level of COL18A1 than mASCs. Furthermore, MVs released by mASCs significantly induced human microvascular endothelial cell migration. CONCLUSION Our study indicates for the first time that the resident ASCs in human epicardial adipose tissue display a depot-specific angiogenic function. Additionally, we have demonstrated that resident stem cells are able to regulate microvascular endothelial cell function by the release of MVs.
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Affiliation(s)
- Carmen Lambert
- Cardiovascular-Program ICCC, IR-Hospital Santa Creu I Sant Pau, IIB Sant Pau, C/Sant Antoni Ma Claret 167, 08025, Barcelona, Spain
| | - Gemma Arderiu
- Cardiovascular-Program ICCC, IR-Hospital Santa Creu I Sant Pau, IIB Sant Pau, C/Sant Antoni Ma Claret 167, 08025, Barcelona, Spain.
| | - Maria Teresa Bejar
- Cardiovascular-Program ICCC, IR-Hospital Santa Creu I Sant Pau, IIB Sant Pau, C/Sant Antoni Ma Claret 167, 08025, Barcelona, Spain
| | - Javier Crespo
- Cardiovascular-Program ICCC, IR-Hospital Santa Creu I Sant Pau, IIB Sant Pau, C/Sant Antoni Ma Claret 167, 08025, Barcelona, Spain
| | - Maribel Baldellou
- Cardiovascular-Program ICCC, IR-Hospital Santa Creu I Sant Pau, IIB Sant Pau, C/Sant Antoni Ma Claret 167, 08025, Barcelona, Spain
| | - Oriol Juan-Babot
- Cardiovascular-Program ICCC, IR-Hospital Santa Creu I Sant Pau, IIB Sant Pau, C/Sant Antoni Ma Claret 167, 08025, Barcelona, Spain
| | - Lina Badimon
- Cardiovascular-Program ICCC, IR-Hospital Santa Creu I Sant Pau, IIB Sant Pau, C/Sant Antoni Ma Claret 167, 08025, Barcelona, Spain.
- Ciber CV, 28029, Madrid, Spain.
- Cardiovascular Research Chair UAB, Barcelona, Spain.
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12
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Kızılgül M, Çalışkan M, Beysel S, Özbek M, Çakal E. Effect of parathyroidectomy on epicardial fat thickness as a cardiovascular risk factor in patients with primary hyperparathyroidism. Turk J Med Sci 2019; 49:1165-1169. [PMID: 31385484 PMCID: PMC7018295 DOI: 10.3906/sag-1902-40] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background/aim Several studies demonstrated that primary hyperparathyroidism is related to increased risk for cardiovascular diseases (CVDs), and risk is decreased by parathyroidectomy. Epicardial fat thickness (EFT) has been postulated as a new marker of CVD risk. We evaluated the impact of parathyroidectomy on EFT in patients with primary hyperparathyroidism (PHPT). Materials and methods Thirty-four PHPT patients (29 female, 5 male) and 28 age- and sex-matched controls (19 female, 9 male) were included in the study. Demographic, anthropometric, and biochemical data were recorded both before parathyroidectomy and 6 months after the procedure. Epicardial fat thickness was measured by transthoracic echocardiography. Results Mean age was 53.15 ± 8.44 years. Mean preoperative EFT was higher than mean EFT in the control group (0.49 ± 0.07 cm to 0.46 ± 0.08 cm, P: 0.0005), and EFT decreased after parathyroidectomy (0.49 ± 0.07 cm to 0.44 ± 0.08 cm, P: 0.0005). Systolic blood pressure and calcium, parathormone, and hsCRP levels decreased after parathyroidectomy (P < 0.05). Vitamin D levels increased (P < 0.05). Diastolic blood pressure, body mass index, carotid intima-media thickness, and HOMA-IR, fasting plasma glucose, and phosphorus levels were unchanged after parathyroidectomy (P > 0.05). Preoperatively, EFT was correlated with SBP (r: 0.360, P: 0.0285) and age (r: 0.466, P: 0.0036). Multiple linear regression used to identify independent predictors of change in epicardial fat did not find any predictor of change in epicardial fat (P > 0.05). Conclusion EFT was decreased by parathyroidectomy in patients with primary hyperparathyroidism.However, the decrease in EFT was not correlated with any of the cardiovascular risk factors. More comprehensive studies evaluating the potential relation between PHPT and EFT need to be conducted.
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Affiliation(s)
- Muhammed Kızılgül
- Department of Endocrinology and Metabolism, University of Health Sciences, Dışkapı Training and Research Hospital, Ankara, Turkey
| | - Mustafa Çalışkan
- Department of Endocrinology and Metabolism, University of Health Sciences, Dışkapı Training and Research Hospital, Ankara, Turkey
| | - Selvihan Beysel
- Department of Endocrinology and Metabolism, University of Health Sciences, Dışkapı Training and Research Hospital, Ankara, Turkey
| | - Mustafa Özbek
- Department of Endocrinology and Metabolism, University of Health Sciences, Dışkapı Training and Research Hospital, Ankara, Turkey
| | - Erman Çakal
- Department of Endocrinology and Metabolism, University of Health Sciences, Dışkapı Training and Research Hospital, Ankara, Turkey
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13
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Song J, Chen X, Jiang Y, Mi J, Zhang Y, Zhao Y, Wu X, Gao H. Association and Interaction Analysis of Lipid Accumulation Product with Impaired Fasting Glucose Risk: A Cross-Sectional Survey. J Diabetes Res 2019; 2019:9014698. [PMID: 31772946 PMCID: PMC6854969 DOI: 10.1155/2019/9014698] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 09/25/2019] [Accepted: 10/01/2019] [Indexed: 12/11/2022] Open
Abstract
AIMS Lipid accumulation product (LAP) is put forward as a powerful marker showing the accumulation of visceral fat. The present study is aimed at (i) analyzing the predictive performances of LAP in the identification of impaired fasting glucose (IFG) in Chinese population and (ii) exploring the potentially interactive effect between LAP and other factors on IFG risk. METHODS Analysis was conducted on the data obtained from a community-based cross-sectional survey in Chinese population, and all the participants enrolled were required to complete a face-to-face questionnaire survey and related health checks. Then, for the purpose of comparing predictive values between LAP and conventional obesity indices for IFG, relevant analysis was carried out on the receiver operating characteristic (ROC) curve. The assessment of interactive effects was conducted by employing the three indicators as follows: (1) RERI (the relative excess risk due to interaction), (2) AP (attributable proportion due to interaction), and (3) SI (synergy index). RESULTS A total of 1777 participants (748 males and 1029 females) were involved in the final analysis. It was finally obtained that the prevalence rate of IFG was 14.1% in total, 15.5% for males and 13.1% for females, respectively. In logistic regression analysis, individuals with LAP levels in the fourth quartile had a significant higher risk of getting IFG in comparison with that of the lowest quartile (crude OR: 4.58, 95% CI: 3.01-6.98; adjusted OR: 3.81, 95% CI: 2.33-6.23). In addition, it was indicated by the ROC curve analysis that LAP showed a better performance in discriminating IFG risk than BMI in both males (Z = 2.20, P = 0.028) and females (Z = 2.13, P = 0.033). However, LAP displayed a higher predictability in comparison with WC only in females (Z = 2.07, P = 0.038), but not in males (Z = 0.18, P = 0.860). Furthermore, LAP and family history of diabetes were able to impose significant synergistic interaction on the risk of IFG, which was indicated by all the parameters in females (RERI: 2.52, 95% CI: 0.19-4.84; AP: 0.47, 95% CI: 0.20-0.74; SI: 2.39, 95% CI: 1.17-4.87) and males (RERI: 2.18, 95% CI: 0.08-4.73; AP: 0.43, 95% CI: 0.07-0.79; SI: 2.15, 95% CI: 1.03-5.45). However, none of the indicators showed significant interaction between LAP and smoking on the risk of IFG in females (RERI: 0.92, 95% CI: -2.79-4.63; AP: 0.20, 95% CI: -0.50-0.92; SI: 1.37, 95% CI: 0.42-4.52). Meanwhile, there was also no significant interaction between LAP and smoking on the risk of IFG in males as indicated by the value of SI (2.22, 95% CI: 0.80-6.21). CONCLUSION It was concluded that LAP was significantly related to a higher risk of IFG in Chinese population, and its performance was superior to that of conventional obesity indices, especially in females. Apart from that, LAP with family history of diabetes may have an interactive effect that can impose a great influence on the development of IFG.
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Affiliation(s)
- Jian Song
- School of Public Health, Bengbu Medical College, 2600 Donghai Road, Bengbu, 233000 Anhui Province, China
| | - Xue Chen
- School of Public Health, Bengbu Medical College, 2600 Donghai Road, Bengbu, 233000 Anhui Province, China
| | - Yuhong Jiang
- School of Public Health, Bengbu Medical College, 2600 Donghai Road, Bengbu, 233000 Anhui Province, China
| | - Jing Mi
- School of Public Health, Bengbu Medical College, 2600 Donghai Road, Bengbu, 233000 Anhui Province, China
| | - Yuyuan Zhang
- School of Public Health, Bengbu Medical College, 2600 Donghai Road, Bengbu, 233000 Anhui Province, China
| | - Yingying Zhao
- Bengbu Health Board, 568 Nanhu Road, Bengbu, 233000 Anhui Province, China
| | - Xuesen Wu
- School of Public Health, Bengbu Medical College, 2600 Donghai Road, Bengbu, 233000 Anhui Province, China
| | - Huaiquan Gao
- School of Public Health, Bengbu Medical College, 2600 Donghai Road, Bengbu, 233000 Anhui Province, China
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Epicardial adipose tissue thickness and type 2 diabetes risk according to the FINDRISC modified for Latin America. CLINICA E INVESTIGACION EN ARTERIOSCLEROSIS 2018; 31:15-22. [PMID: 30166212 DOI: 10.1016/j.arteri.2018.06.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 05/15/2018] [Accepted: 06/16/2018] [Indexed: 11/21/2022]
Abstract
BACKGROUND The Finnish Diabetes Risk Score (FINDRISC) is a tool to predict 10-year risk of type 2 diabetes mellitus (T2DM), and visceral adiposity is associated with higher cardio-metabolic risk. The objective of the study was to assess the relationship of epicardial adipose tissue (EAT) thickness with T2DM risk according to the FINDRISC tool. METHODS The study was conducted in Ciudad Bolívar, Venezuela, and included 55 subjects of whom 37 (67.3%) were women and 18 (32.7%) men with ages between 18 and 75 years. A record was made of weight, height, body mass index (BMI), waist circumference (WC), fasting glucose, baseline insulin, plasma lipids, Homeostasis Model Assessment-Insulin Resistance (HOMA-IR), and EAT thickness. The FINDRISC tool, with WC cut-off points modified for Latin America (LA-FINDRISC) was used. RESULTS BMI, WC, plasma insulin concentration, HOMA-IR index, and EAT thickness were higher (P<0.0001) in the high-risk group compared to subjects in the low-moderate risk group according to the LA-FINDRISC. LA-FINDRISC was positively correlated with BMI (r=0.513; P=0.0001), WC (r=0.524; P=0.0001), fasting blood glucose (r=0.396; P=0.003); baseline plasma insulin (r=0.483; P=0.0001); HOMA-IR index (r=0.545; P=.0.0001); and EAT thickness (r=0.702; P=0.0001). The multivariate regression analysis showed that fasting blood glucose (P=0.023) and EAT thickness (P=0.007) remained independently associated with high T2DM risk. CONCLUSIONS LA-FINDRISC was associated with EAT thickness and insulin resistance markers. Both were independently and directly associated with high risk for diabetes in the LA-FINDRISC category.
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15
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Song J, Zhao Y, Nie S, Chen X, Wu X, Mi J. The effect of lipid accumulation product and its interaction with other factors on hypertension risk in Chinese Han population: A cross-sectional study. PLoS One 2018; 13:e0198105. [PMID: 29874254 PMCID: PMC5991403 DOI: 10.1371/journal.pone.0198105] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 05/14/2018] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES Lipid accumulation product (LAP) is a simple and effective indicator that reflects visceral obesity. This study aimed to compare the significance of LAP in predicting hypertension risk with other obesity indices, and to evaluate the interactive effects of LAP and smoking, family history of hypertension on hypertension risk in Chinese Han adults. METHODS A community based cross-sectional study was performed in Bengbu, China. Participants received face-to-face questionnaire survey, anthropometric tests and laboratory examinations. Relevant indicators that reflect obesity including BMI (body mass index), waist-to-height ratio (WHtR) and LAP were calculated. Multivariate logistic regression analysis was applied to explore the association between LAP and hypertension risk. The area under the receiver-operating characteristics curves (AUC) of LAP, BMI, and WHtR were calculated and then compared. Interactive effect was evaluated by relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP) and synergy index (SI). RESULTS A total of 1777 participants were enrolled, and the prevalence of hypertension was 24.4% (n = 433). There was a significant increase in hypertension risk with LAP levels in the fourth quartile as compared with the bottom quartile (OR: 3.31, 95%CI: 1.76-6.25). The AUC of LAP was significantly different than that of BMI in males (Z = 2.158, p = 0.0309) and females (Z = 3.570, p = 0.0004), while only performed better in females as compared with that of WHtR (Z = 2.166, p = 0.0303). LAP was significantly interacted with family history of hypertension on hypertension risk both in males (RERI: 1.07, 95%CI: 0.09-2.05; AP: 0.33, 95%CI: 0.23-0.44; SI: 1.92, 95%CI: 1.53-2.41) and females (RERI: 0.80, 95%CI: 0.07-1.53; AP: 0.25, 95%CI: 0.11-0.39; SI: 1.59, 95%CI: 1.16-2.19). However, a significant interaction between LAP and smoking was only observed in males (RERI: 1.32, 95%CI: 0.15-2.75; AP: 0.40, 95% CI: 0.14-0.73). CONCLUSION Increased LAP was significantly associated with a higher risk of hypertension in Chinese Han adults. Moreover, the effect of LAP on predicting hypertension risk was better than that of other obesity indices. Our results also demonstrated interactive effects of LAP with smoking, family history of hypertension on hypertension risk.
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Affiliation(s)
- Jian Song
- School of public health, Bengbu medical college, Bengbu, Anhui Province, China
| | | | - Sumei Nie
- Bengbu health board, Bengbu, Anhui Province, China
| | - Xue Chen
- School of public health, Bengbu medical college, Bengbu, Anhui Province, China
| | - Xuesen Wu
- School of public health, Bengbu medical college, Bengbu, Anhui Province, China
| | - Jing Mi
- School of public health, Bengbu medical college, Bengbu, Anhui Province, China
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16
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Luna-Luna M, Cruz-Robles D, Ávila-Vanzzini N, Herrera-Alarcón V, Martínez-Reding J, Criales-Vera S, Sandoval-Zárate J, Vargas-Barrón J, Martínez-Sánchez C, Tovar-Palacio AR, Fragoso JM, Carreón-Torres E, Vargas-Alarcón G, Pérez-Méndez Ó. Differential expression of osteopontin, and osteoprotegerin mRNA in epicardial adipose tissue between patients with severe coronary artery disease and aortic valvular stenosis: association with HDL subclasses. Lipids Health Dis 2017; 16:156. [PMID: 28821297 PMCID: PMC5563041 DOI: 10.1186/s12944-017-0550-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 08/14/2017] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Previous studies suggest a relationship of the epicardial adipose tissue (EAT) with progression and calcification of the atherosclerotic plaque; however, it is unknown if this tissue expresses genes that may participate on these processes and if the expression of these genes is regulated by high-density lipoprotein (HDL) subclasses. METHODS To explore this possibility, we determined the mRNA expression by qPCR of a pro-calcifying gene (osteopontin (OPN)), and two anti-calcifying genes (osteoprotegerin (OPG) and osteonectin (ON)), in biopsies of EAT obtained from 15 patients with coronary artery disease (CAD) determined by angiography, and 15 patients with diagnostic of aortic valve stenosis but without CAD as control group. We determined the distribution and composition of HDL subclasses by electrophoresis and their statistical relationship with the gene expression in EAT. RESULTS EAT from CAD patients showed a higher expression level of OPN and OPG than control group, whereas ON expression was similar between groups. Large HDL subclasses were cholesterol-poor in CAD patients as estimated by the cholesterol-to-phospholipid ratio. A linear regression model showed an independent association of OPN expression with HDL3a-cholesterol, and OPG expression with the relative proportion of HDL3b protein. Logistic analysis determined that OPN expression was positively associated with the presence of atherosclerotic plaque CONCLUSION: OPN, ON, and OPG genes are transcribed in EAT; to the exception of ON, the level of expression was different in CAD patients and control group, and correlated with some HDL subclasses, suggesting a new role of these lipoproteins.
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Affiliation(s)
- María Luna-Luna
- Department of Molecular Biology, Instituto Nacional de Cardiología "Ignacio Chávez", Juan Badiano 1, Sección XVI, 14080, México City, D.F., Mexico
| | - David Cruz-Robles
- Department of Molecular Biology, Instituto Nacional de Cardiología "Ignacio Chávez", Juan Badiano 1, Sección XVI, 14080, México City, D.F., Mexico
| | - Nydia Ávila-Vanzzini
- Department of Echocardiography, Instituto Nacional de Cardiología "Ignacio Chávez", México City, Mexico
| | - Valentín Herrera-Alarcón
- Department of Cardiothoracic Surgery, Instituto Nacional de Cardiología "Ignacio Chávez", México City, Mexico
| | - Jesús Martínez-Reding
- Department of Adult Cardiology, Instituto Nacional de Cardiología "Ignacio Chávez", México City, Mexico
| | - Sergio Criales-Vera
- Department of Radiology, Instituto Nacional de Cardiología "Ignacio Chávez", México City, Mexico.,Study Group of Atherosclerosis, Instituto Nacional de Cardiología "Ignacio Chávez", México City, Mexico
| | - Julio Sandoval-Zárate
- Department of Cardiopulmonary, Instituto Nacional de Cardiología "Ignacio Chávez", México City, Mexico.,Study Group of Atherosclerosis, Instituto Nacional de Cardiología "Ignacio Chávez", México City, Mexico
| | - Jesús Vargas-Barrón
- Department of Echocardiography, Instituto Nacional de Cardiología "Ignacio Chávez", México City, Mexico.,Study Group of Atherosclerosis, Instituto Nacional de Cardiología "Ignacio Chávez", México City, Mexico
| | - Carlos Martínez-Sánchez
- Department of Emergency, Instituto Nacional de Cardiología "Ignacio Chávez", México City, Mexico.,Study Group of Atherosclerosis, Instituto Nacional de Cardiología "Ignacio Chávez", México City, Mexico
| | - Armando Roberto Tovar-Palacio
- Department of Physiology of Nutrition, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", México City, Mexico
| | - José Manuel Fragoso
- Department of Molecular Biology, Instituto Nacional de Cardiología "Ignacio Chávez", Juan Badiano 1, Sección XVI, 14080, México City, D.F., Mexico.,Study Group of Atherosclerosis, Instituto Nacional de Cardiología "Ignacio Chávez", México City, Mexico
| | - Elizabeth Carreón-Torres
- Department of Molecular Biology, Instituto Nacional de Cardiología "Ignacio Chávez", Juan Badiano 1, Sección XVI, 14080, México City, D.F., Mexico.,Study Group of Atherosclerosis, Instituto Nacional de Cardiología "Ignacio Chávez", México City, Mexico
| | - Gilberto Vargas-Alarcón
- Department of Molecular Biology, Instituto Nacional de Cardiología "Ignacio Chávez", Juan Badiano 1, Sección XVI, 14080, México City, D.F., Mexico.,Study Group of Atherosclerosis, Instituto Nacional de Cardiología "Ignacio Chávez", México City, Mexico
| | - Óscar Pérez-Méndez
- Department of Molecular Biology, Instituto Nacional de Cardiología "Ignacio Chávez", Juan Badiano 1, Sección XVI, 14080, México City, D.F., Mexico. .,Study Group of Atherosclerosis, Instituto Nacional de Cardiología "Ignacio Chávez", México City, Mexico.
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17
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Imga NN, Ucar Elalmis O, Muslum Tuna M, Aycıcek Dogan B, Sahin D, Berker D, Guler S. The Relationship Between Increased Epicardial Fat Thickness and Left Ventricular Hypertrophy and Carotid Intima-Media Thickness in Patients With Nonfunctional Adrenal Incidentaloma. Int J Endocrinol Metab 2016; 14:e37635. [PMID: 27942264 PMCID: PMC5138281 DOI: 10.5812/ijem.37635] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2016] [Revised: 06/15/2016] [Accepted: 06/26/2016] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Emerging evidences indicate that patients diagnosed with Adrenal Incidentaloma (AI) may present cardiovascular complications. Epicardial fat thickness (EFT) has recently been described as a new risk factor and an active player in metabolic syndrome and cardiovascular disease. OBJECTIVES We aimed to evaluate the relationship between EFT and left ventricular hypertrophy and carotid intima-media thickness, which are both strong predictors of cardiovascular morbity and mortality, in patients with nonfunctioning AI. PATIENTS AND METHODS We evaluated 51 patients (36 females and 15 males) diagnosed with AI and 35 (29 females, 6 males) age, gender and body mass index (BMI) matched healthy controls in terms of cardiovascular risk parameters. Epicardial fat was identified as the echo-free space between the outer wall of the myocardium and the visceral layer of the pericardium. RESULTS Epicardial fat thickness was significantly higher in patients with AI when compared to the control group (0.89 ± 0.32 cm vs. 0.74 ± 0.26 cm; P = 0.023). left ventricular (LV) mass index and median carotid intima-media thickness (CIMT) were also higher in subjects with AI than in controls (99.8 g/m2 vs. 86.9 g/m2; P = 0.024 and 7.5 mm (5.5 - 11.5) vs. 6.5 mm (4.5 - 9.5); P = 0.017). There was a positive correlation between EFT, LV mass index, EFT and CIMT (r = 0.315, P = 0.004; r = 0.363, P < 0.001; respectively). CONCLUSIONS In this study we showed that EFT, measured by echocardiography is higher in subjects with AI when compared to healthy controls. epicardial fat thickness had the best independent correlation with AI in multiple logistic regression analysis. Incidentaloma is also associated with increased left ventricular mass index and CIMT. Adrenal incidentaloma patients may show early cardiac changes, such as increased left ventricular mass and increased CIMT.
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Affiliation(s)
- Nasiroglu Narin Imga
- Ankara Numune Education and Research Hospital, Department of Endocrinology, Ankara, Turkey
- Corresponding author: Nasiroglu Narin Imga, Ankara Numune Education and Research Hospital, Department of Endocrinology, Ankara, Turkey. Tel: +90-5056492934, Fax: +90-3124263838, E-mail:
| | - Ozgul Ucar Elalmis
- Ankara Numune Education and Research Hospital, Department of Cardiology, Ankara, Turkey
| | - Mazhar Muslum Tuna
- Ankara Numune Education and Research Hospital, Department of Endocrinology, Ankara, Turkey
| | - Bercem Aycıcek Dogan
- Ankara Numune Education and Research Hospital, Department of Endocrinology, Ankara, Turkey
| | - Deniz Sahin
- Ankara Numune Education and Research Hospital, Department of Cardiology, Ankara, Turkey
| | - Dilek Berker
- Ankara Numune Education and Research Hospital, Department of Endocrinology, Ankara, Turkey
| | - Serdar Guler
- Ankara Numune Education and Research Hospital, Department of Endocrinology, Ankara, Turkey
- Department of Endocrinology, Faculty of Medicine, Hitit University, Corum, Turkey
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Lima-Martínez MM, Paoli M, Rodney M, Balladares N, Contreras M, D'Marco L, Iacobellis G. Effect of sitagliptin on epicardial fat thickness in subjects with type 2 diabetes and obesity: a pilot study. Endocrine 2016; 51:448-55. [PMID: 26233684 DOI: 10.1007/s12020-015-0710-y] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 07/28/2015] [Indexed: 01/11/2023]
Abstract
The aim of the study was to assess the effect of sitagliptin addition on the epicardial adipose tissue (EAT) thickness in subjects with type 2 diabetes mellitus inadequately controlled on metformin monotherapy. This was a 24-week interventional pilot study in 26 consecutive type 2 diabetic patients, 14 females and 12 males average age of 43.8 ± 9.0 years, with Hemoglobin A1c (HbA1c) ≥ 7% on metformin monotherapy. Subjects who met the inclusion criteria were added on sitagliptin and started on sitagliptin/metformin combination at the dosage of 50 mg/1000 mg twice daily. EAT and visceral and total body fat were measured, respectively, with echocardiography and bioelectrical impedance analysis at baseline and after 24 weeks of sitagliptin/metformin treatment in each subject. HbA1c and plasma lipids were also measured. EAT decreased significantly from 9.98 ± 2.63 to 8.10 ± 2.11 mm, p = 0.001, accounting for a percentage of reduction (∆%) of -15% after 24 weeks of sitagliptin addition, whereas total body fat percentage, visceral fat, and body mass index (BMI), decreased by 8, 12, and 7%, respectively (p = 0.001 for all). After 6 month, EAT ∆% was significantly correlated with ∆% of visceral fat (r = 0.456; p = 0.01), whereas no correlation with either BMI ∆% (r = 0.292; p = 0.147) or HbA1c ∆% was found. The addition of Sitagliptin produced a significant and rapid reduction of EAT, marker of organ-specific visceral fat, in overweight/obese individuals with type 2 diabetes inadequately controlled on metformin monotherapy. EAT as measured with ultrasound can serve as no invasive and accurate marker of visceral fat changes during pharmaceutical interventions targeting the fat.
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Affiliation(s)
- Marcos M Lima-Martínez
- Departamento de Ciencias Fisiológicas, Universidad de Oriente, Núcleo Bolívar, Ciudad Bolívar, Venezuela.
- Anexo A Centro Médico Orinoco, Unidad de Endocrinología, Diabetes, Metabolismo y Nutrición, Ciudad Bolívar, Venezuela.
| | - Mariela Paoli
- Instituto Autónomo Hospital Universitario de los Andes, Unidad de Endocrinología, Mérida, Venezuela
| | - Marianela Rodney
- Servicio de Cardiología, Hospital Universitario Ruíz y Páez, Ciudad Bolívar, Venezuela
| | - Nathalie Balladares
- Departamento de Ciencias Fisiológicas, Universidad de Oriente, Núcleo Bolívar, Ciudad Bolívar, Venezuela
- Anexo A Centro Médico Orinoco, Unidad de Endocrinología, Diabetes, Metabolismo y Nutrición, Ciudad Bolívar, Venezuela
| | | | - Luis D'Marco
- Clínica Puerto Ordaz, Unidad Avanzada de Investigación y Diagnóstico Ecográfico y Renal (UNIRENAL), Ciudad Guayana, Venezuela
| | - Gianluca Iacobellis
- Division of Endocrinology, Department of Medicine, University of Miami Miller School of Medicine, Miami, USA
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Reyes Y, Paoli M, Camacho N, Molina Y, Santiago J, Lima-Martínez MM. Epicardial adipose tissue thickness in children and adolescents with cardiometabolic risk factors. ACTA ACUST UNITED AC 2015; 63:70-8. [PMID: 26654426 DOI: 10.1016/j.endonu.2015.09.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 09/07/2015] [Accepted: 09/08/2015] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To assess the relationship of epicardial adipose tissue (EAT) thickness with cardiometabolic risk factors (CRFs) in children and adolescents. METHODS Seventy-seven subjects of both sexes aged 7-18 years were selected. Medical history, clinical parameters, and glucose, insulin, and lipid levels were collected. EAT thickness was measured using transthoracic echocardiography. Study subjects were divided into two groups based on whether they had less than two or two or more CRFs. RESULTS The group with two or more CRFs had higher EAT thickness, insulin, and HOMA-IR values (P<.05). EAT thickness showed a statistically significant positive correlation with body mass index (BMI) (r=0.561, P=.0001), waist circumference (r=.549, P=.0001), systolic blood pressure (SBP) (r=.256, P=.028), insulin (r=0.408, P=.0001), and HOMA-IR (r=.325, P=.005). However, these correlations were not significant after adjustment for BMI. The cut-off point for EAT thickness as predictor of two or more CRFs was 3.17mm. The risk (odds ratio) of having two or more CRFs if EAT thickness was >3.17mm was 3.1 (95% CI: 1.174-8.022). BMI was the independent variable that most affected EAT thickness and the presence of two or more CRFs. CONCLUSION In this group of children and adolescents, the relationship of EAT thickness with CRFs was found to be dependent on BMI.
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Affiliation(s)
- Yubriangel Reyes
- Unidad de Endocrinología, Instituto Autónomo Hospital Universitario de los Andes, Mérida, Venezuela
| | - Mariela Paoli
- Unidad de Endocrinología, Instituto Autónomo Hospital Universitario de los Andes, Mérida, Venezuela.
| | - Nolis Camacho
- Unidad de Nutrición, Crecimiento y Desarrollo Infantil, Instituto Autónomo Hospital Universitario de los Andes, Mérida, Venezuela
| | - Yudisay Molina
- Instituto de Investigaciones Cardiovasculares, Instituto Autónomo Hospital Universitario de los Andes, Mérida, Venezuela
| | - Justo Santiago
- Instituto de Investigaciones Cardiovasculares, Instituto Autónomo Hospital Universitario de los Andes, Mérida, Venezuela
| | - Marcos M Lima-Martínez
- Departamento de Ciencias Fisiológicas, Universidad de Oriente, Núcleo Bolívar, Ciudad Bolívar, Venezuela
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Luna-Luna M, Medina-Urrutia A, Vargas-Alarcón G, Coss-Rovirosa F, Vargas-Barrón J, Pérez-Méndez Ó. Adipose Tissue in Metabolic Syndrome: Onset and Progression of Atherosclerosis. Arch Med Res 2015; 46:392-407. [PMID: 26009250 DOI: 10.1016/j.arcmed.2015.05.007] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 05/12/2015] [Indexed: 12/25/2022]
Abstract
Metabolic syndrome (MetS) should be considered a clinical entity when its different symptoms share a common etiology: obesity/insulin resistance as a result of a multi-organ dysfunction. The main interest in treating MetS as a clinical entity is that the addition of its components drastically increases the risk of atherosclerosis. In MetS, the adipose tissue plays a central role along with an unbalanced gut microbiome, which has become relevant in recent years. Once visceral adipose tissue (VAT) increases, dyslipidemia and endothelial dysfunction follow as additive risk factors. However, when the nonalcoholic fatty liver is present, risk of a cardiovascular event is highly augmented. Epicardial adipose tissue (EAT) seems to increase simultaneously with the VAT. In this context, the former may play a more important role in the development of the atherosclerotic plaque than the latter. Hence, EAT may act as a paracrine tissue vis-à-vis the coronary arteries favoring the local inflammation and the atheroma calcification.
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Affiliation(s)
- María Luna-Luna
- Department of Molecular Biology, Instituto Nacional de Cardiología, Mexico City, Mexico
| | | | - Gilberto Vargas-Alarcón
- Department of Molecular Biology, Instituto Nacional de Cardiología, Mexico City, Mexico; Study Group of Atherosclerosis, Instituto Nacional de Cardiología, Mexico City, Mexico
| | | | - Jesús Vargas-Barrón
- Echocardiography, Instituto Nacional de Cardiología, Mexico City, Mexico; Study Group of Atherosclerosis, Instituto Nacional de Cardiología, Mexico City, Mexico
| | - Óscar Pérez-Méndez
- Department of Molecular Biology, Instituto Nacional de Cardiología, Mexico City, Mexico; Study Group of Atherosclerosis, Instituto Nacional de Cardiología, Mexico City, Mexico.
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21
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del Busto-Mesa A, Cabrera-Rego JO, Carrero-Fernández L, Hernández-Roca CV, González-Valdés JL, de la Rosa-Pazos JE. Changes in arterial stiffness, carotid intima-media thickness, and epicardial fat after L-thyroxine replacement therapy in hypothyroidism. ACTA ACUST UNITED AC 2015; 62:270-6. [PMID: 25882083 DOI: 10.1016/j.endonu.2015.02.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Revised: 02/03/2015] [Accepted: 02/16/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To assess the relationship between primary hypothyroidism and subclinical atherosclerosis and its potential changes with L-thyroxine replacement therapy. METHODS A prospective cohort study including 101 patients with primary hypothyroidism and 101 euthyroid patients as controls was conducted from July 2011 to December 2013. Clinical, anthropometrical, biochemical, and ultrasonographic parameters were assessed at baseline and after one year of L-thyroxine replacement therapy. RESULTS At baseline, hypothyroid patients had significantly greater values of blood pressure, total cholesterol, VLDL cholesterol, left ventricular mass, epicardial fat, and carotid intima-media thickness as compared to controls. Total cholesterol, VLDL cholesterol, ventricular diastolic function, epicardial fat, carotid intima-media thickness, carotid local pulse wave velocity, pressure strain elastic modulus, and β arterial stiffness index showed a significant and positive correlation with TSH levels. After one year of replacement therapy, patients with hypothyroidism showed changes in total cholesterol, VLDL cholesterol, TSH, carotid intima-media thickness, and arterial stiffness parameters. CONCLUSIONS Primary hypothyroidism is characterized by an increased cardiovascular risk. In these patients, L-thyroxine replacement therapy for one year is related to decreased dyslipidemia and improvement in markers of subclinical carotid atherosclerosis.
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Talman AH, Psaltis PJ, Cameron JD, Meredith IT, Seneviratne SK, Wong DTL. Epicardial adipose tissue: far more than a fat depot. Cardiovasc Diagn Ther 2015; 4:416-29. [PMID: 25610800 DOI: 10.3978/j.issn.2223-3652.2014.11.05] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Accepted: 11/17/2014] [Indexed: 01/04/2023]
Abstract
Epicardial adipose tissue (EAT) refers to the fat depot that exists on the surface of the myocardium and is contained entirely beneath the pericardium, thus surrounding and in direct contact with the major coronary arteries and their branches. EAT is a biologically active organ that may play a role in the association between obesity and coronary artery disease (CAD). Given recent advances in non-invasive imaging modalities such a multidetector computed tomography (MDCT), EAT can be accurately measured and quantified. In this review, we focus on the evidence suggesting a role for EAT as a quantifiable risk marker in CAD, as well as describe the role EAT may play in the development and vulnerability of coronary artery plaque.
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Affiliation(s)
- Andrew H Talman
- 1 Monash Heart, Monash Cardiovascular Research Centre & Monash University, Clayton, Victoria, Australia ; 2 South Australian Health & Medical Research Institute (SAHMRI), Adelaide, Australia
| | - Peter J Psaltis
- 1 Monash Heart, Monash Cardiovascular Research Centre & Monash University, Clayton, Victoria, Australia ; 2 South Australian Health & Medical Research Institute (SAHMRI), Adelaide, Australia
| | - James D Cameron
- 1 Monash Heart, Monash Cardiovascular Research Centre & Monash University, Clayton, Victoria, Australia ; 2 South Australian Health & Medical Research Institute (SAHMRI), Adelaide, Australia
| | - Ian T Meredith
- 1 Monash Heart, Monash Cardiovascular Research Centre & Monash University, Clayton, Victoria, Australia ; 2 South Australian Health & Medical Research Institute (SAHMRI), Adelaide, Australia
| | - Sujith K Seneviratne
- 1 Monash Heart, Monash Cardiovascular Research Centre & Monash University, Clayton, Victoria, Australia ; 2 South Australian Health & Medical Research Institute (SAHMRI), Adelaide, Australia
| | - Dennis T L Wong
- 1 Monash Heart, Monash Cardiovascular Research Centre & Monash University, Clayton, Victoria, Australia ; 2 South Australian Health & Medical Research Institute (SAHMRI), Adelaide, Australia
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Epicardial fat thickness as cardiovascular risk factor and therapeutic target in patients with rheumatoid arthritis treated with biological and nonbiological therapies. ARTHRITIS 2014; 2014:782850. [PMID: 25574390 PMCID: PMC4276696 DOI: 10.1155/2014/782850] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2014] [Revised: 11/23/2014] [Accepted: 11/24/2014] [Indexed: 12/17/2022]
Abstract
Rheumatoid arthritis (RA) is a chronic inflammatory disease associated with high cardiovascular morbidity and mortality. Epicardial adipose tissue (EAT) thickness may act as a therapeutic target during treatments with drugs modulating the adipose tissue. We evaluate EAT thickness in RA patients treated with biological and nonbiological disease-modifying antirheumatic drugs (DMARDs). A cross-sectional study was conducted with a cohort of 34 female RA patients and 16 controls matched for age and body mass index (BMI). Plasma glucose, basal insulin, plasma lipids, and high-sensitivity C-reactive protein (hs-CRP) were assessed. EAT thickness and left ventricular mass (LVM) were measured by echocardiography. No significant differences in waist circumference (WC), blood pressure, fasting blood glucose, basal insulin, and lipid parameters were found between the groups. The control group showed lower concentrations (P = 0.033) of hs-CRP and LVM (P = 0.0001) than those of the two RA groups. Patients treated with TNF-α inhibitors showed significantly lower EAT thickness than those treated with nonbiological DMARDs (8.56 ± 1.90 mm versus 9.71 ± 1.45 mm; P = 0.04). Women with no RA revealed reduced EAT thickness (5.39 ± 1.52 mm) as compared to all RA patients (P = 0.001). Results suggest that RA patients have greater EAT thickness than controls regardless of BMI and WC.
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Serrano-Ferrer J, Walther G, Crendal E, Vinet A, Dutheil F, Naughton G, Lesourd B, Chapier R, Courteix D, Obert P. Right ventricle free wall mechanics in metabolic syndrome without type-2 diabetes: effects of a 3-month lifestyle intervention program. Cardiovasc Diabetol 2014; 13:116. [PMID: 25407698 PMCID: PMC4149206 DOI: 10.1186/s12933-014-0116-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Accepted: 07/20/2014] [Indexed: 01/18/2023] Open
Abstract
Background Growing evidence demonstrates subtle left ventricular myocardial dysfunction in patients with metabolic syndrome (MetS), with central obesity, glucose intolerance and inflammation emerging as important contributors. Whether these results can be translated to the right ventricle (RV) is not yet fully elucidated. Furthermore, although lifestyle intervention favorably impacts MetS components and inflammatory biomarkers, its effect on RV myocardial function remains unknown today. Methods Thirty-nine MetS adults free of diabetes were enrolled in a three month lifestyle intervention program including diet and physical exercise, and compared with forty healthy controls. Blood biochemistry, echocardiography including tissue Doppler imaging (TDI), and vector velocity imaging of the RV free wall to assess global longitudinal strain (GLS) and strain rates (SR) were obtained at baseline and after the intervention. Results Compared with controls, MetS patients presented similar right atrial and RV morphology but reduced systolic (P = 0.04) and early diastolic (P = 0.02) velocities of the tricuspid annulus. They showed attenuated RV GLS (−21.4 ± 4.5vs-25.7 ± 4.9%, P < 0.001) as well as early diastolic (P = 0.003) and systolic (P < 0.001) SR. Multiple regression analyses revealed log PAI-1 active, (P < 0.001), log adiponectin, (P = 0.01), LV mass indexed (P = 0.004) and central fat (P = 0.03) as independent predictors of RV GLS (R2 = 0.46, P < 0.001). Biological markers of MetS and inflammation as well as RV GLS (−21.8 ± 3.8vs-24.3 ± 3.0%, P = 0.009) and systolic (P = 0.003) and early diastolic (P = 0.01) SR, but not TDI indexes, significantly improved after diet and exercise training, and vector velocity imaging data in MetS following the lifestyle intervention no longer differed from controls. Conclusions MetS is associated with subtle impairments in both RV free wall diastolic and systolic myocardial function which could be partly related to central-obesity induced changes in pro- and anti-inflammatory cytokines and left ventricular remodeling. The favorable impact of healthy dieting and physical activity on RV free wall mechanics indicates that cellular and sub-cellular alterations responsible for the RV myocardial abnormalities are probably not permanent and modifiable throughout adequate interventional strategies. Trial registration American National Institutes of Health database NCT00917917.
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Lima-Martínez MM, Paoli M, Donis JH, Odreman R, Torres C, Iacobellis G. [Cut-off point of epicardial adipose tissue thickness for predicting metabolic syndrome in Venezuelan population]. ACTA ACUST UNITED AC 2013; 60:570-6. [PMID: 23791773 DOI: 10.1016/j.endonu.2013.03.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2012] [Revised: 02/27/2013] [Accepted: 03/04/2013] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To define an echocardiographically-assessed cut-off point for epicardial adipose tissue (EAT) thickness associated to metabolic syndrome (MS) components in Venezuelan subjects. METHODS Fifty-two subjects aged 20-65 years diagnosed with MS according to International Diabetes Federation criteria and 45 sex- and age-matched controls were selected. Blood glucose and plasma lipids were tested; EAT thickness and left ventricular mass were measured by echocardiography. RESULTS No significant age and sex differences were found between the two groups. Body weight, body mass index, waist circumference, and systolic and diastolic blood pressure were significantly higher (P=.0001) in the MS group. This group showed significantly higher levels of fasting blood glucose (P=.0001), total cholesterol (P=.002), LDL-C (P=.007), non-HDL-C (P=.0001), triglycerides (P=.0001), Tg-HDL-C ratio (P=.0001), and lower HDL-C levels (P=.0001) as compared to the control group. EAT thickness (P=.0001) and left ventricular mass (P=.017) were significantly higher in the MS group. The ROC curve showed an AUC of 0.852 (P=.0001) with a power of the test of 0.99. A 5-mm EAT thickness showed a sensitivity of 84.62% (95%CI: 71.9-93.1) and a specificity of 71.11% (95%CI: 55.7-83.6) for predicting MS. The odds ratio of this population for experiencing MS due to an EAT ≥ 5 mm was 8.25 (95%CI: 3.15-21.56; P=.0001). CONCLUSION An EAT value ≥ 5 mm has good sensitivity and specificity for predicting MS in the Venezuelan population.
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Affiliation(s)
- Marcos M Lima-Martínez
- Departamento de Ciencias Fisiológicas, Escuela de Ciencias de la Salud, Universidad de Oriente, Núcleo Bolívar, Ciudad Bolívar, Venezuela.
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