Influence Of Pericardial Adipose Tissue On Insulin Resistance And Cardiovascular Risk Factors

Objective:The purpose of this study was to explore the correlation between pericardial adipose tissue (PAT) volume,epicardial adipose tissue (EAT) volume, paracardial adipose tissue (PAT2) volume and HOMA-IR, Body mass index(BMI), blood pressure, lipid profile, 10-year ischemic cardiovascular disease (ICVD) risks. Moreover, volumes of PAT, EAT, and PAT2 were also analyzed in predicting HOMA-IR and 10-year absolute risk of ICVD.Insulin resistance (IR) was assessment by HOMA-IR. EAT volume, Overall risk of cardiovascular disease is assessment by the tools of the 10-year absolute risk of ICVD. volumes of PAT, EAT, and PAT2 were assessment by 64-slice CT.Methods:From September 2014 to December 2015, we enrolled inpatients from the department of cardiology of Hospital on Integration of Chinese and Western Medicine Affiliated to Nanjing University of Chinese Medicine. We included patients with chest tightness, chest pain who may have coronary heart disease and patients suffering from coronary heart disease and requiring a coronary artery CT examination. Those in pregnancy, or lactating, or having serious liver and kidney dysfunction, severe heart disease, severe acute respiratory disease were excluded. Volumes of PAT, EAT,PAT2 were measured by using 64-slice CT imaging and we also measured height, weight, blood pressure, lipid profile(TC,TG,HDL LDL), of all subjects, The oral glucose tolerance test was used to measure fasting plasma glucose(FPG) and fasting serum insulin (FINS). The cut-off point(2.11) of insulin resistance was defined as HOMA-IR exceeding the 75th percentile of the distribution in 81 normal glucose tolerance subjects, HOMA-IR≥2.11 was defined as insulin resistance.Results:A total of 158 subjects involving 78 male and 80 female enrolled into this study. EAT volume of patients suffering from Coronary heart disease was significantly higher than those without Coronary heart disease (P=0.014). Volumes of PAT (P<0.001),EAT (P=0.006) and PAT2 (P<0.001) were significantly higher in men than in women and they were also higher in overweight, obese patients or patients with diabetes, prediabetes or those with insulin resistance, or having high 10-year absolute risk of ICVD.Volumes of PAT,EAT and PAT2 were respectively positively correlated with age, systolic blood pressure, BMI, waist circumference, hip circumference, fasting insulin, HOMA -IR, TG,10-year score of ICVD,10-year absolute risk of ICVD, total energy consumption of sedentary (P<0.05 or P<0.01). Volumes of PAT, PAT2 were positively correlated with LDL (P<0.05). PAT volume, EAT volume, PAT2 volume was negatively correlated with HDL total physical activity energy consumption, total middle intensity physical activity energy consumption (P<0.01). In addition, the EAT volume was negatively correlated with total walking energy consumption (r=-0.184, P=0.021) and PAT2 volume was negatively correlated with the total sleep energy consumption (r=-0.175,.P=0.027).Adjusting for gender and BMI by multivariable analysis, volumes of PAT, PAT2, EAT were still respectively positively correlated with age,10-year ischemic score of ICVD, total energy consumption of sedentary (P<0.01). EAT volume was positively correlated with waist circumference (r=0.169,P=0.035),and was negatively correlated with HDL (r=-0.159, P=0.048).PAT2 volume was positively correlated with TC, LDL (P< 0.05). Volumes of PAT, EAT, PAT2 were still respectively negatively correlated with total physical activity energy consumption (P<0.05). By using unary linear regression, we found that Volumes of PAT, EAT, PAT2 were risk factors of 10-year risks of ICVD and HOMA-IR. PAT volume had a greater influence on HOMA-IR compared to EAT volume and PAT2 volume. EAT volume had a greater influence on 10-year risks of ICVD than PAT volume and PAT2 volume.Conclusion:1) EAT have played an important role in the process of coronary heart disease.2) Volumes of PAT、EAT、PAT2 were associated with HOMA-IR, the 10-year absolute risk of ICVD, cardiovascular risk factors (age, systolic blood pressure, BMI, waist circumference, hip circumference, TG, LDL).3) Volumes of PAT、EAT、PAT2 were influence factors of HOMA-IR and 10-year absolute risk of ICVD. Furthermore, PAT volume is a better predictor of HOMA-IR compared to EAT volume and PAT2 volume. EAT volume is a better predictor of the 10-year absolute risk of ICVD compared to PAT volume and PAT2 volume.