Association of Epicardial, Visceral, and Subcutaneous Fat With Cardiometabolic Diseases

作者：Sato Fumi; Maeda Norikazu^*; Yamada Takayuki; Namazui Hideyuki; Fukuda Shiro; Natsukawa Tomoaki; Nagao Hirofumi; Murai Jun; Masuda Shigeki; Tanaka Yoshimitsu; Obata Yoshinari; Fujishima Yuya; Nishizawa Hitoshi; Funahashi Tohru; Shimomura Iichiro

来源：Circulation Journal, 2018, 82(2): 502-508.

DOI：10.1253/circj.CJ-17-0820

• Adiponectin
• Atherosclerosis
• Epicardial fat
• Metabolic syndrome
• Visceral fat

Background: Excess of visceral fat is a central factor in the pathogenesis of metabolic syndrome (MetS) and atherosclerosis. However, little is known about how much epicardial fat affects cardiometabolic disorders in comparison with visceral or subcutaneous fat.
Methods and Results: Participants suspected as having angina pectoris underwent cardiac computed tomography (CT) imaging. Of them, 374 subjects were analyzed the association of clinical characteristics and CT-based fat distribution measured as epicardial fat volume (EFV), visceral fat area (VFA), and subcutaneous fat area (SFA). EFV was highly associated with VFA (R=0.58). Serum adiponectin was significantly decreased in high VFA subjects (VFA >= 100 cm(2)) and was also reduced in the high EFV group (EFV >= 80 cm(3)). Among the low VFA groups, the numbers of subjects with diabetes and coronary atherosclerosis were increased in high EFV group. Among the low EFV groups, the numbers of subjects with diabetes, hyperuricemia, and coronary atherosclerosis were increased among the high VFA subjects. In an age-, sex-, and body mass index (BMI)-adjusted model, EFV was associated with dyslipidemia and MetS, and VFA was significantly associated with hypertension, dyslipidemia, MetS, and coronary atherosclerosis, while SFA was not related with coronary risks and atherosclerosis.
Conclusions: Epicardial fat accumulation may be a risk for coronary atherosclerosis in subjects without visceral fat accumulation. Visceral fat is the strongest risk for cardiometabolic diseases among the 3 types of fat depot.

• 出版日期2018-2