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Epicardial Adipose Tissue Volume and Adipocytokine Imbalance Are Strongly Linked to Human Coronary Atherosclerosis

Michio ShimabukuroFrom the Department of Cardio-Diabetes Medicine (M. Shimabukuro., D.F.), Department of Cardiovascular Medicine (M. Shimabukuro, Y.H., M.D., H.S., D.F., T.S., M. Sata), Department of Cardiovascular Surgery (H.K., T.K.), and Department of Nutrition and Metabolism (H.S.), The University of Tokushima Graduate School of Health Biosciences, Tokushima, Japan; Department of Pediatrics, Graduate School of Medicine, University of Tokyo, Tokyo, Japan (Y.H.); Department of Radiology, Health Sciences UniversityYoichiro HirataFrom the Department of Cardio-Diabetes Medicine (M. Shimabukuro., D.F.), Department of Cardiovascular Medicine (M. Shimabukuro, Y.H., M.D., H.S., D.F., T.S., M. Sata), Department of Cardiovascular Surgery (H.K., T.K.), and Department of Nutrition and Metabolism (H.S.), The University of Tokushima Graduate School of Health Biosciences, Tokushima, Japan; Department of Pediatrics, Graduate School of Medicine, University of Tokyo, Tokyo, Japan (Y.H.); Department of Radiology, Health Sciences UniversityMinoru TabataFrom the Department of Cardio-Diabetes Medicine (M. Shimabukuro., D.F.), Department of Cardiovascular Medicine (M. Shimabukuro, Y.H., M.D., H.S., D.F., T.S., M. Sata), Department of Cardiovascular Surgery (H.K., T.K.), and Department of Nutrition and Metabolism (H.S.), The University of Tokushima Graduate School of Health Biosciences, Tokushima, Japan; Department of Pediatrics, Graduate School of Medicine, University of Tokyo, Tokyo, Japan (Y.H.); Department of Radiology, Health Sciences UniversityMunkhbaatar DagvasumberelFrom the Department of Cardio-Diabetes Medicine (M. Shimabukuro., D.F.), Department of Cardiovascular Medicine (M. Shimabukuro, Y.H., M.D., H.S., D.F., T.S., M. Sata), Department of Cardiovascular Surgery (H.K., T.K.), and Department of Nutrition and Metabolism (H.S.), The University of Tokushima Graduate School of Health Biosciences, Tokushima, Japan; Department of Pediatrics, Graduate School of Medicine, University of Tokyo, Tokyo, Japan (Y.H.); Department of Radiology, Health Sciences UniversityHiromi SatoFrom the Department of Cardio-Diabetes Medicine (M. Shimabukuro., D.F.), Department of Cardiovascular Medicine (M. Shimabukuro, Y.H., M.D., H.S., D.F., T.S., M. Sata), Department of Cardiovascular Surgery (H.K., T.K.), and Department of Nutrition and Metabolism (H.S.), The University of Tokushima Graduate School of Health Biosciences, Tokushima, Japan; Department of Pediatrics, Graduate School of Medicine, University of Tokyo, Tokyo, Japan (Y.H.); Department of Radiology, Health Sciences UniversityHirotsugu KurobeFrom the Department of Cardio-Diabetes Medicine (M. Shimabukuro., D.F.), Department of Cardiovascular Medicine (M. Shimabukuro, Y.H., M.D., H.S., D.F., T.S., M. Sata), Department of Cardiovascular Surgery (H.K., T.K.), and Department of Nutrition and Metabolism (H.S.), The University of Tokushima Graduate School of Health Biosciences, Tokushima, Japan; Department of Pediatrics, Graduate School of Medicine, University of Tokyo, Tokyo, Japan (Y.H.); Department of Radiology, Health Sciences UniversityDaiju FukudaFrom the Department of Cardio-Diabetes Medicine (M. Shimabukuro., D.F.), Department of Cardiovascular Medicine (M. Shimabukuro, Y.H., M.D., H.S., D.F., T.S., M. Sata), Department of Cardiovascular Surgery (H.K., T.K.), and Department of Nutrition and Metabolism (H.S.), The University of Tokushima Graduate School of Health Biosciences, Tokushima, Japan; Department of Pediatrics, Graduate School of Medicine, University of Tokyo, Tokyo, Japan (Y.H.); Department of Radiology, Health Sciences UniversityTakeshi SoekiFrom the Department of Cardio-Diabetes Medicine (M. Shimabukuro., D.F.), Department of Cardiovascular Medicine (M. Shimabukuro, Y.H., M.D., H.S., D.F., T.S., M. Sata), Department of Cardiovascular Surgery (H.K., T.K.), and Department of Nutrition and Metabolism (H.S.), The University of Tokushima Graduate School of Health Biosciences, Tokushima, Japan; Department of Pediatrics, Graduate School of Medicine, University of Tokyo, Tokyo, Japan (Y.H.); Department of Radiology, Health Sciences UniversityTetsuya KitagawaFrom the Department of Cardio-Diabetes Medicine (M. Shimabukuro., D.F.), Department of Cardiovascular Medicine (M. Shimabukuro, Y.H., M.D., H.S., D.F., T.S., M. Sata), Department of Cardiovascular Surgery (H.K., T.K.), and Department of Nutrition and Metabolism (H.S.), The University of Tokushima Graduate School of Health Biosciences, Tokushima, Japan; Department of Pediatrics, Graduate School of Medicine, University of Tokyo, Tokyo, Japan (Y.H.); Department of Radiology, Health Sciences UniversityShuichiro TakanashiFrom the Department of Cardio-Diabetes Medicine (M. Shimabukuro., D.F.), Department of Cardiovascular Medicine (M. Shimabukuro, Y.H., M.D., H.S., D.F., T.S., M. Sata), Department of Cardiovascular Surgery (H.K., T.K.), and Department of Nutrition and Metabolism (H.S.), The University of Tokushima Graduate School of Health Biosciences, Tokushima, Japan; Department of Pediatrics, Graduate School of Medicine, University of Tokyo, Tokyo, Japan (Y.H.); Department of Radiology, Health Sciences UniversityMasataka SataFrom the Department of Cardio-Diabetes Medicine (M. Shimabukuro., D.F.), Department of Cardiovascular Medicine (M. Shimabukuro, Y.H., M.D., H.S., D.F., T.S., M. Sata), Department of Cardiovascular Surgery (H.K., T.K.), and Department of Nutrition and Metabolism (H.S.), The University of Tokushima Graduate School of Health Biosciences, Tokushima, Japan; Department of Pediatrics, Graduate School of Medicine, University of Tokyo, Tokyo, Japan (Y.H.); Department of Radiology, Health Sciences University
2013en
ABI

Annotatsiya

OBJECTIVE: The impact of epicardial adipose tissue (EAT) over abdominal or overall adiposity on coronary artery disease (CAD) is currently unknown. We compared the association among EAT volume (EATV), cytokine/adipocytokine profiles in EAT and subcutaneous fat, and atherogenic CAD. APPROACH AND RESULTS: Paired samples were obtained from EAT and subcutaneous adipose tissue during elective cardiac surgery for CAD (n=50) or non-CAD (n=50). EATV was the sum of cross-sectional EAT areas, and visceral and subcutaneous fat areas were determined at the umbilicus level on computed tomography scans. CD68(+), CD11c(+), and CD206(+) cells were counted using immunohistochemical staining. Cytokine/adipocytokine expression was evaluated using quantitative real-time polymerase chain reaction. Multivariate analysis indicated that male sex, age, diabetes mellitus, high triglycerides, and low high-density lipoprotein cholesterol, and EATV index (EATV/body surface area, cm(3)/m(2)) were significant CAD predictors (corrected R(2)=0.401; P<0.001); visceral fat area, hypertension, smoking, low-density lipoprotein cholesterol (140 mg/dL [3.63 mmol/L]) or statin use were not predictors. The EATV index positively correlated with the CD68(+) and CD11c(+) cell numbers and nucleotide-binding domain, leucine-rich-containing family, pyrin domain-containing-3 (NLRP3), interleukin-1β, and interleukin-1R expression; and negatively correlated with adiponectin expression in EAT. A multivariate analysis model, including CD68(+) cells and interleukin-1β, and adiponectin expression in EAT strongly predicted CAD (corrected R(2)=0.756; P<0.001). CONCLUSIONS: EATV and macrophage and cytokine/adipocytokine signals in EAT strongly correlated with CAD. Our findings suggest that EATV and adipocytokine imbalance are strongly linked to human coronary atherosclerosis.

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