Objective: This cross-sectional study aimed to address the relationship between the volume of epicardial adipose tissue (EAT) with cardiovascular risk factors and coronary artery calcification(CAC) in the community residents. Methods: Individuals were recruited from the Jidong Community (Tangshan City, Northern China) which mainly comprised employees of the Jidong Co. Ltd. and their family members. From July 2013 to August 2014, 2 647 participants aged ≥40 years were included in this study. The volume of EAT and coronary artery calcification score (CAC score) were determined by a 64-slice CT. Carotid intima-media thickness (CIMT) was measured by a trained sonographer using a high-resolution B-mode topographic ultrasound system. Venous blood samples were analyzed by automated analyzers in the central laboratory. A validated questionnaire specifically designed for this study was used to collect demographic data from all participants by trained doctors. Characteristics of study cohort were compared according to quartiles of EAT volume (n=660, 663, 662, 662, repectively). Results: (1) The mean age of participants was (55.31±7.76) years and 49.94% (n=1 322) were men. The median EAT volume (interquartile) was 129.42 (95.66, 176.51)cm(3). (2) Age, BMI, waist circumference and hip circumference, systolic blood pressure, LDL-C, triglycerides, and fasting blood glucose were significantly higher, while HDL-C level was significantly lower in participants with higher EAT volume than participants with lower EAT volume (all P<0.05). Carotid intima-media thicken (CIMT) and higher CAC score were also significantly higher in participants with higher volume of EAT. Furthermore, percentage of diabetes mellitus, hypertension, hyperlipidemia increased in proportion with increasing EAT volume (P<0.05). (3) In the linear regression, significant positive relations were found for age (β=0.019 3, 95%CI 0.017-0.021, P<0.001), waist circumference (β=0.012 7, 95%CI 0.009-0.016, P<0.001), BMI (β=0.022 4, 95%CI 0.013-0.032, P<0.001), LDL-C (β=0.048 4, 95%CI 0.021-0.076, P<0.001), and HDL-C (β=-0.098 1, 95%CI-0.164--0.032, P<0.001) was inversely related to the EAT volume. (4) Logistic regression analysis indicated that EAT volume was an independent risk factor for CAC score>0 (OR=1.233, 95%CI 1.205-1.262, P<0.001) . Conclusions: Our findings indicate that EAT volume is strongly correlated to cardiovascular risk factors and coronary calcification and is an independent risk factor of increased coronary calcification in community residents.
目的： 探讨社区人群中心外膜脂肪（EAT）体积与冠心病传统危险因素以及冠状动脉钙化（CAC）积分之间的关联性。 方法： 收集2013年7月至2014年8月河北省唐山市冀东社区人群的体检资料。社区体检人群行64排双源CT测定EAT体积以及CAC积分，超声测量颈动脉内膜中层厚度（CIMT），测量血压、身高、体重、腰围等，同期行血脂、肝肾功能、空腹血糖（FBG）等各项生化指标检测，通过问卷调查人群的既往病史、吸烟史等一般资料。共2 647名居民入选本次研究，按照人群EAT体积的四分位数对该人群进行分组，各组的人数分别为660、663、662、662名。通过单因素线性回归和多因素logistic回归分析EAT体积与各项传统冠心病危险因素以及CAC积分和CIMT的关系。 结果： （1）人群年龄为（55.31±7.76）岁，男性占总人群的49.94%（1 322/2 647）。总人群的EAT体积为129.42（95.66，176.51）cm(3)。（2）随着EAT体积的增加，各组间冠心病的各项危险因素如年龄、腰围、体重指数、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、FBG水平、CIMT异常率、CAC积分异常率等差异均有统计学意义（P均<0.05）。（3）在单因素线性回归分析中，与EAT体积存在相关性的因素分别为年龄（β=0.019 3，95%CI 0.017~0.021，P<0.001）、腰围（β=0.012 7，95%CI 0.009~0.016，P<0.001）、BMI（β=0.022 4，95%CI 0.013~0.032，P<0.001）、LDL-C（β=0.048 4，95%CI 0.021~0.076，P<0.001）、女性（β=-0.142 7，95%CI-0.188~-0.097，P<0.001）和HDL-C（β=-0.098 1，95%CI-0.164~-0.032，P<0.001）。（4）多因素logistic回归分析显示，EAT体积是冠状动脉钙化积分异常（CAC积分>0）的独立影响因素（OR=1.233，95%CI 1.205~1.262，P<0.001）。 结论： EAT体积与传统冠心病危险因素和CAC积分密切相关。.
Keywords: Coronary artery calcium; Coronary disease; Epicardial adipose tissue; Risk factors.