Relationship between the Echocardiographic Epicardial Adipose Tissue Thickness and Serum Adiponectin in Patients with Angina

Kyeong Ho Yun; Sang Jae Rhee; Nam Jin Yoo; Seok Kyu Oh; Nam-Ho Kim; Jin-Won Jeong; Do-Sim Park; Hyun-Young Park

doi:10.4250/jcu.2009.17.4.121

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Yun, Rhee, Yoo, Oh, Kim, Jeong, Park, and Park: Relationship between the Echocardiographic Epicardial Adipose Tissue Thickness and Serum Adiponectin in Patients with Angina

Original Article

J Cardiovasc Ultrasound 2009;17(4):121-126.

Published online: 31 December 2009

DOI: https://doi.org/10.4250/jcu.2009.17.4.121

Relationship between the Echocardiographic Epicardial Adipose Tissue Thickness and Serum Adiponectin in Patients with Angina

Kyeong Ho Yun^1,², Sang Jae Rhee¹, Nam Jin Yoo¹, Seok Kyu Oh^1,², Nam-Ho Kim^1,², Jin-Won Jeong², Do-Sim Park², Hyun-Young Park²

¹Department of Cardiovascular Medicine, Wonkwang University Hospital, Iksan, Korea

²Institute of Wonkwang Medical Science, Wonkwang University College of Medicine, Iksan, Korea

Address for Correspondence: Jin-Won Jeong, Department of Cardiovascular Medicine, Wonkwang University Hospital, 344-2 Sinnyong-dong, Iksan 570-711, Korea Tel: +82-63-859-2521, Fax: +82-63-852-8480, E-mail: jjwcar@wonkwang.ac.kr

Received 20 July 2009 Revised 2 November 2009 Accepted 30 November 2009

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background

It is still unknown whether increased cardiac adiposity is related to the risk factors of coronary artery disease (CAD). We measured epicaridal adopose tissue (EAT) and mediastinal adipose tissue (MAT) using echocardiography and examined their correlations with CAD and serum adiponectin.

Methods

One hundred fifty three patients who underwent elective coronary angiography for chest pain were measured cardiac adiposity by transthoracic echocardiography. The correlations of cardiac adipose tissue with the presence and severity of CAD and the serum adiponectin level were examined.

Results

EAT was thicker in patients with CAD (1.8±1.4 vs. 3.8±1.9 mm, p<0.001), but MAT was not different according to the presence of CAD (2.9±2.8 vs. 3.5±2.5 mm, p=0.121). EAT showed a significant positive correlation with age (r=0.225, p=0.005), homocystein (r=0.289, p=0.001), fasting glucose (r=0.167, p=0.042), and fibrinogen (r=0.218, p=0.009), and a significant negative correlation with serum adiponectin (r=-0.194, p=0.016). EAT thickness (OR 11.53, 95% CI; 3.61-36.84, p<0.001) and low serum adiponectin (OR 2.88, 95% CI; 1.02-8.15, p=0.046) were independent predictors of obstructive CAD. However, MAT thickness was not associated with CAD.

Conclusion

EAT was associated with the severity and risk factors of CAD and correlated with serum adiponectin level. In contrast with EAT, MAT was not associated with CAD and adiponectin.

Keywords: Epicardium, Adiponectin, Coronary artery disease, Echocardiography

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Fig. 1.

Echocardiographic measurement of epicardial adipose tissue and mediastinal adipose tissue. EAT: epicardial adipose tissue, MAT: mediastinal adipose tissue.

Fig. 2.

Correlation between serum adiponectin level and epicaridal adipose tissue according to gender. EAT: epicardial adipose tissue.

Fig. 3.

Cardiac adipose tissue and serum adiponectin level according to the severity of coronary artery disease. ^*p<0.05.

Table 1.

Baseline characteristics

	CAD (-) (n=68)	CAD (+) (n=85)	p value
Age (years)	58.1±10.0	62.5±10.1	0.010
Male sex (%)	26 (38.2)	44 (51.8)	0.095
Hypertension (%)	36 (52.9)	58 (68.2)	0.053
Diabetes mellitus (%)	10 (14.7)	30 (35.3)	0.004
Current smoker (%)	12 (17.6)	23 (27.1)	0.168
BMI (kg/m²)	25.1±3.3	25.4±3.1	0.647
Total cholesterol (mg/dL)	189.3±36.8	208.6±43.8	0.004
Triglyceride (mg/dL)	143.5±84.8	169.7±95.5	0.079
HDL cholesterol (mg/dL)	49.9±11.0	46.1±11.0	0.032
LDL cholesterol (mg/dL)	108.6±33.9	125.4±36.8	0.004
baPWV (m/s)	14.9±2.4	15.4±2.7	0.264
Ankle brachial index	1.1±0.7	1.0±1.1	0.001
Epicardial adipose tissue (mm)	1.8±1.4	3.8±1.9	<0.001
Mediastinal adipose tissue (mm)	2.9±2.8	3.5±2.5	0.121
Serum adiponectine (µg/mL)	8.2±7.1	5.9±4.7	0.019

CAD: coronary artery disease, BMI: body mass index, HDL: high density lipoprotein, LDL: low density lipoprotein, baPWV: brachio-ankle pulse wave velocity

Table 2.

Correlation between the cardiac adipose tissue thickness and clinical variables

Variables	Epicardial adipose tissue		Mediastinal adipose tissue		Pericardial adipose tissue
Variables	r	p	r	p	r	p
Age	0.225	0.005^*	0.099	0.224	0.210	0.009^*
BMI	0.012	0.882	0.185	0.023^†	0.183	0.024^†
baPWV	0.045	0.502	-0.044	0.634	0.003	0.975
WBC count	0.089	0.275	-0.003	0.974	0.049	0.545
Total cholesterol	0.125	0.124	0.075	0.354	0.126	0.120
HDL cholesterol	-0.146	0.072	0.066	0.417	-0.024	0.769
Homocysteine	0.289	0.001^*	0.025	0.769	0.221	0.015^†
Glucose	0.167	0.042^†	0.011	0.895	0.112	0.172
hsCRP	0.115	0.160	0.020	0.809	0.111	0.171
Fibrinogen	0.218	0.009^*	0.057	0.497	0.203	0.015^†
Adiponectin	-0.194	0.016^†	0.107	0.188	-0.025	0.762

^* p<0.01,

^† p<0.05.

BMI: body mass index, baPWV: brachio-ankle pulse wave velocity, WBC: white blood cell, HDL: high density lipoprotein, hsCRP: high sensitivity C-reactive protein

Table 3.

Multiple regression analysis for prediction of the presence of significant coronary artery disease

Variable	OR (99% CI)	p value
EAT thickness (≥2.6 mm)	11.53 (3.61-36.84)	<0.001
hsCRP (≥1.1 mg/L)	6.16 (2.19-17.33)	0.001
Diabetes	4.99 (1.48-16.82)	0.009
Age (≥65 years)	3.72 (1.33-10.39)	0.012
LDL cholesterol (≥118 mg/dL)	3.31 (1.27-8.58)	0.014
low serum adiponectin (<5.5 µg/mL)	2.88 (1.02-8.15)	0.046
PAT thickness (≥5.7 mm)	2.51 (0.65-9.70)	0.182
Hypertension	1.73 (0.60-4.98)	0.314
low HDL cholesterol (<46 mg/dL)	1.35 (0.51-3.52)	0.545
MAT thickness (≥3.2 mm)	1.45 (0.42-4.97)	0.555
Serum creatinine (≥0.99 mg/dL)	1.02 (0.39-2.65)	0.973

For continuous variables, the median value was used as a cut-off point. EAT: epicardial adipose tissue, hsCRP: high sensitivity C-reactive protein, LDL: low density lipoprotein, PAT: pericardial adipose tissue, HDL: high density lipoprotein, MAT: mediastinal adipose tissue

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