Association of Epicardial Adipose Tissue With Cardiometabolic Risk and Metabolic Syndrome in Patients With Rheumatoid Arthritis
Article first published online: 26 AUG 2013
Copyright © 2013 by the American College of Rheumatology
Arthritis Care & Research
Volume 65, Issue 9, pages 1410–1415, September 2013
How to Cite
Ormseth, M. J., Lipson, A., Alexopoulos, N., Hartlage, G. R., Oeser, A. M., Bian, A., Gebretsadik, T., Shintani, A., Raggi, P. and Stein, C. M. (2013), Association of Epicardial Adipose Tissue With Cardiometabolic Risk and Metabolic Syndrome in Patients With Rheumatoid Arthritis. Arthritis Care Res, 65: 1410–1415. doi: 10.1002/acr.22027
- Issue published online: 26 AUG 2013
- Article first published online: 26 AUG 2013
- Accepted manuscript online: 16 APR 2013 08:54AM EST
- Manuscript Accepted: 27 MAR 2013
- Manuscript Received: 3 DEC 2012
- NIH. Grant Numbers: P60-AR056116, T32-AR059039, HL-67964, UL-1TR000445
Patients with rheumatoid arthritis (RA) have increased coronary atherosclerosis possibly related to increased prevalence of visceral adiposity, insulin resistance, and metabolic syndrome. Epicardial adipose tissue (EAT), a type of visceral fat, may contribute to cardiometabolic risk. The aim of this study was to measure EAT volume in patients with RA and determine its relationship with cardiometabolic risk markers and coronary artery calcium.
EAT volume and coronary artery calcium score were measured by noncontrast cardiac computed tomography and compared in RA patients (n = 162) and controls (n = 89). The relationships between EAT volume and markers of cardiometabolic risk in RA were examined with adjustment for age, race, and sex.
Among RA patients, EAT volume was positively associated with interleukin-6 (P = 0.03), triglycerides (P = 0.004), hypertension (P = 0.01), homeostatic model of insulin resistance (HOMA) (P < 0.001), smoking history (P = 0.04), and homocysteine level (P = 0.001), and negatively associated with high-density lipoprotein (P = 0.005). With further adjustment for waist circumference (a measure of visceral obesity), EAT volume remained independently associated with triglycerides, HOMA, current smoking, and homocysteine level (all P < 0.05). EAT volume was not associated with corticosteroid use or coronary artery calcium score. Patients with metabolic syndrome had significantly greater EAT volume (P < 0.001) and each increase in metabolic syndrome criteria was associated, on average, with a 20% increase (95% confidence interval 14–26%) in EAT volume (P < 0.001).
EAT volume is associated with metabolic syndrome and cardiometabolic risk factors, including insulin resistance, triglycerides, current smoking, and homocysteine levels, but not with coronary artery calcium in RA patients.