Grasa epicárdica en la población general de mediana edad y su asociación con el síndrome metabólico / Epicardial adipose tissue in the general middle-aged population and its association with metabolic syndrome

RESUMEN

Introducción y objetivos: Actualmente hay cada vez más interés en el tejido adiposo epicárdico (TAE) como marcador de enfermedad cardiovascular. Nuestro objetivo es describir el TAE medido por ecocardiograma, y determinar su asociación con el síndrome metabólico (SM), dentro del estudio poblacional RIVANA. Métodos: Se incluyó a 880 sujetos de 45 a 74 años (492 con SM según la definición armonizada). Se realizó una exploración física y se tomó una muestra sanguínea para obtener el perfil bioquímico. Se midió el espesor del TAE con ecocardiografía transtorácica al final de la sístole. Resultados: Entre los sujetos sin SM, la prevalencia de TAE ≥ 5 mm aumentaba significativamente con la edad (> 65 frente a 45-54 años, OR = 8,22; IC95%, 3,90-17,35; p lineal < 0,001). El TAE se asoció significativamente con el SM (5.o frente a 1.er quintil, OR = 3,26; IC95%, 1,59-6,71; p lineal = 0,001). Respecto a los criterios individuales, el TAE se asoció independientemente con los criterios colesterol unido a lipoproteínas de alta densidad bajo (5.o frente a 1.er quintil, OR = 2,65; IC95%, 1,16-6,05; p lineal = 0,028), triglicéridos altos (5.o frente a 1.er quintil, OR = 2,22; IC95%, 1,26-3,90; p lineal = 0,003) y elevado perímetro abdominal (5.o frente a 1.er quintil, OR = 6,85; IC95%, 2,91-16,11; p lineal < 0,001). Conclusiones En una submuestra de la población general, la grasa epicárdica aumentó significativa e independientemente con la edad, y su incremento se asoció independientemente con el SM, el colesterol unido a lipoproteínas de alta densidad bajo, los triglicéridos altos y un elevado perímetro abdominal (AU)

ABSTRACT

Introduction and objectives: There is currently increasing interest in epicardial adipose tissue (EAT) as a marker of cardiovascular disease. Our purpose was to describe EAT, measured by transthoracic echocardiography, and to assess its association with metabolic syndrome (MS) in the RIVANA population-based study. Methods: Physical examination was performed in 880 participants aged 45 to 74 years (492 of them with MS according to the harmonized definition). Fasting glucose, high-density lipoprotein cholesterol, triglyceride, and C-reactive protein concentrations were determined in a blood sample. In all participants, EAT thickness was measured with transthoracic echocardiography at end-systole. Results: Among participants without MS, the prevalence of EAT ≥ 5 mm significantly increased with age (OR > 65 years vs 45-54 years = 8.22; 95%CI, 3.90-17.35; P for trend < .001). Increasing EAT quintiles were significantly associated with MS (OR fifth quintile vs first quintile = 3.26; 95%CI, 1.59-6.71; P for trend = .001). Considering the different MS criteria, increasing quintiles of EAT were independently associated with low high-density lipoprotein cholesterol (OR fifth quintile vs first quintile = 2.65; 95%CI, 1.16-6.05; P for trend = .028), high triglycerides (OR fifth quintile vs first quintile = 2.22; 95%CI, 1.26-3.90; P for trend = .003), and elevated waist circumference (OR fifth quintile vs first quintile = 6.85; 95%CI, 2.91-16.11; P for trend < .001). Conclusions: In a subsample of the general population, EAT measured by echocardiography increased significantly and independently with age. Increased EAT thickness was independently associated with MS and with low high-density lipoprotein cholesterol, high triglycerides, and elevated waist circumference as individual criteria (AU)