Associations of pericardial and intrathoracic fat with coronary calcium presence and progression in a multiethnic study

Authors

  • Christina L. Wassel,

    Corresponding author
    • Division of Preventive Medicine, Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, California, USA
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  • Gail A. Laughlin,

    1. Division of Epidemiology, Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, California, USA
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  • Maria Rosario G. Araneta,

    1. Division of Epidemiology, Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, California, USA
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  • Eugene Kang,

    1. Division of Preventive Medicine, Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, California, USA
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  • Cindy M. Morgan,

    1. Division of Preventive Medicine, Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, California, USA
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  • Elizabeth Barrett-Connor,

    1. Division of Epidemiology, Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, California, USA
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  • Matthew A. Allison

    1. Division of Preventive Medicine, Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, California, USA
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  • Disclosure: The authors declare no conflicts of interest.

  • Funding agencies: This work was supported by R21HL089622 from the National Heart Lung and Blood Institute to CLW. GAL was supported by an American Heart Association award.

Correspondence: Christina L. Wassel (cwassel@ucsd.edu)

Abstract

Objective

Body mass index (BMI) may not accurately or adequately reflect body composition or its role in the development of cardiovascular disease (CVD). Ectopic adipose depots may provide a more refined representation of the role of adiposity in CVD. Thus, the association of pericardial and intra-thoracic fat with coronary artery calcium (CAC) was examined.

Design and Methods

Nearly 600 white men and women, as well as Filipina women and African-American women, all without known CVD, had abdominal and chest computed tomography (CT) scans at two time points about 4 years apart from which CAC presence, severity and progression, as well as pericardial and intrathoracic fat volumes were obtained. Logistic and linear regression models with staged adjustment were used to assess associations of pericardial and intra-thoracic fat with CAC presence, severity, and progression.

Results

After adjustment for age, BMI, sex/ethnic group, ever smoking, and lipids, each standard deviation higher increment of intra-thoracic fat, but not pericardial fat, was significantly associated with 3.84-fold higher odds of prevalent CAC (95% CI (1.54, 9.58), P = 0.004) and a 38.4% higher CAC score (95% CI (3.5%, 90.0%), P = 0.03). Neither pericardial nor intrathoracic fat were associated with CAC progression.

Conclusions

Contrary to previous reports, pericardial fat was not associated with the presence, severity or progression of CAC. However, a significant association between intrathoracic fat and both the presence and severity of CAC was demonstrated. Studies measuring fat in the thoracic cavity may consider defining intrathoracic fat as a separate entity from pericardial fat.

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