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Relations of Epicardial Adipose Tissue Measured by Multidetector Computed Tomography to Components of the Metabolic Syndrome Are Region-Specific and Independent of Anthropometric Indexes and Intraabdominal Visceral Fat

Division of Cardiology, Department of Internal Medicine (T.-D.W., Y.-T.L., M.-F.C.), and Departments of Medical Imaging (W.-J.L., Y.-C.C.) and Emergency Medicine (F.-Y.S., C.-H.H., W.-J.C.), National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 100, Taiwan, Republic of China

Address all correspondence and requests for reprints to: Tzung-Dau Wang, M.D., Ph.D., Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, no. 7, Zhong-Shan South Road, Taipei, 100, Taiwan, Republic of China. E-mail: tdwang{at}ntu.edu.tw.

Context: Epicardial adipose tissue (EAT) is a metabolically active visceral fat depot. Its distribution is asymmetrical and primarily concentrated in the grooves. To date, it remains unclear which measurement of EAT best reflects its metabolic risk.

Objective: We aimed to examine the correlations between various multidetector computed tomographic measurements of EAT, metabolic syndrome components, and plasma levels of high-sensitivity C-reactive protein and adipokines.

Design, Setting, and Participants: This study included 148 consecutive patients undergoing multidetector computed tomography prior to diagnostic coronary angiography. Thickness in the grooved segments, cross-sectional areas, and total volume of EAT were measured. The cross-sectional areas of sc and visceral abdominal fat depots were additionally measured in 70 randomly selected patients.

Results: Thickness of EAT in the left atrioventricular groove was the only EAT measurement significantly correlated with all three metabolic syndrome components (blood pressure, lipid, and glucose components) and plasma levels of resistin and high-sensitivity C-reactive protein after age and gender adjustments. The association between left atrioventricular groove thickness and increasing number of metabolic syndrome components remained significant after additional adjustments for body mass index, waist circumference, and intraabdominal visceral fat area. By using the receiver operating characteristic analysis, the optimal cutoff point for left atrioventricular groove thickness to predict the presence of at least two metabolic syndrome components was 12.4 mm.

Conclusions: A simple measurement of EAT thickness in the left atrioventricular groove may provide a more accurate assessment of metabolic risk associated with EAT, which could not be accounted for by anthropometric indexes and intraabdominal visceral fat.