Pericardial Fat Is Associated With Impaired Lung Function and a Restrictive Lung Pattern in Adults

Abstract

Background: Impaired lung function has been linked to obesity and systemic infl ammation. Pericardial fat has been shown to be associated with anomalies in cardiac structure, function, and atherosclerosis. We hypothesized that pericardial fat may have a similar role in the impairment of lung function. Methods: Cross-sectional associations of pericardial fat volumes, quantifi ed by multidetector CT scan, with FEV 1 and FVC assessed by spirometry, were investigated in 1,293 participants (54.5 Ϯ 10.8 years; 66.4% women) in the Jackson Heart Study. We also examined whether these associations were independent of visceral adipose tissue (VAT). Results: Pericardial fat was associated with impaired lung function after multivariable adjustment, but these associations generally did not remain after adjustment for VAT. An exception was the FEV 1 /FVC ratio. Higher pericardial fat volumes were associated with higher odds of a restrictive lung pattern and lower odds of airway obstruction. Participants in the highest quartile had the highest odds of a restrictive lung pattern (OR, 1.85; 95% CI, 1.22-2.79, compared with quartile 1), even after adjustment for VAT. The odds of obstruction decreased across increasing quartiles of pericardial fat. These relationships were generally graded, suggesting dose-response trends. Conclusions: Pericardial fat is generally associated with lower lung function and independently associated with a restrictive lung pattern in middle-aged and elderly adults. Further research is needed to fully understand the mechanisms through which pericardial fat contributes to pulmonary anomalies.CHEST 2011; 140(6):1567-1573Abbreviations: AT 5 adipose tissue; ATS 5 American Thoracic Society; CRP 5 C-reactive protein; CVD 5 cardiovascular disease; LLN 5 lower limit of normal; PASP 5 pulmonary artery systolic pressure; RV 5 right ventricular; SAT 5 subcutaneous adipose tissue; VAT 5 visceral adipose tissue; WC 5 waist circumference

Epidemiology, genetics, and subtyping of preserved ratio impaired spirometry (PRISm) in COPDGene

“…Although obesity has been associated with proportionate decreases in FEV 1 and FVC as well as decreases in TLC, lung function values of obese subjects typically remain within the normal range [ 32 ]; thus the degree of impairment in lung function in PRISm subjects is unlikely to be due solely to the mechanical properties of increased body mass. This supposition is supported by the divergent trends in the prevalence of overweight and obesity relative to PRISm over the last half century (Additional file 1 : Figure S10); the dramatic increase in the prevalence of overweight and obesity [ 33 ] is not reflected in the relatively stable prevalence of PRISm [ 7 – 9 , 11 – 13 , 15 , 16 , 22 , 31 , 34 ].…”

“…They report increased respiratory symptoms [ 9 , 16 , 19 ], decreased exercise capacity [ 12 , 19 ], more difficulty with the activities of daily living [ 12 , 15 ], and have evidence of increased systemic inflammation [ 20 ]. Additional trends which have emerged include associations between PRISm and increased body mass index (BMI) [ 6 , 9 , 10 , 15 ], diabetes mellitus [ 8 , 12 , 13 , 18 , 21 ], cardiovascular disease [ 9 , 13 , 18 , 22 ], and cigarette smoke exposure [ 6 , 10 , 13 , 15 , 18 ]. While these summary statistics among all PRISm subjects are useful, they fail to capture the significant heterogeneity present within this group; for example, while the mean BMI of this cohort is typically higher than that of the general population, the range of BMI observed can include frankly cachectic subjects [ 8 , 10 , 12 , 13 , 15 , 18 ].…”

Belastungsuntersuchungen in der Pneumologie – Empfehlungen der Deutschen Gesellschaft für Pneumologie und Beatmungsmedizin e. V.

“…Auch Studien, welche Adipositas nicht durch BMI, sondern durch die abdominale oder thorakale Fettverteilung mittels MRT [330], Computertomografie [331], anthropometrischer Daten [332] bzw. Ultraschall [333] detektieren, zeigen vergleichbare lungenfunktionelle Veränderungen.…”

Reversibility of Intrathoracic Lipotoxicity in Obesity After Bariatric Surgery

“…A large number of alterations mediated by bioactive molecules and cellular mechanisms (e.g., infiltration of macrophages) may occur in epicardial fat, contributing to detrimental effects on cardiac function, coronary vasculature, and pulmonary function (1,3,4). Macrophages play a central role in promoting the inflammatory response in adipose tissue in obesity-related disorders.…”