Sex differences in pericardial adipose tissue assessed by PET/CT and association with cardiometabolic risk

Abstract

Background Recent studies suggest that pericardial adipose tissue (PAT) is associated with whole body adiposity and insulin resistance. Moreover, the incidence of cardiovascular disease (CVD) differs between men and women. Although CVD is more prevalent in men, women suffering from CVD have a higher mortality compared to men. Differences in PAT may account for some of the observed sex differences in manifestations of CVD. Purpose To assess pericardial adipose tissue (PAT) as a biomarker for cardiometabolic risk and to assess potential sex differences. Material and Methods We studied 303 individuals (151 women, 152 men; mean age = 57 ± 17 years) across the weight spectrum. PAT and abdominal adipose tissue were quantified using clinical computed tomography (CT) scans obtained as part of a positron emission tomography (PET)/CT. Cardiometabolic risk factors were assessed from medical records. Linear regression and receiver operating characteristic (ROC) curve analyses were performed to evaluate associations between PAT and cardiometabolic risk. Results PAT was higher in overweight and obese individuals compared to lean individuals and higher in men compared to women. PAT was positively associated with body mass index, abdominal fat ( P < 0.0001), fasting glucose, and serum lipids ( P < 0.05) with stronger associations in women than in men. PAT was accurate in detecting the prevalence of the metabolic syndrome with 74% sensitivity and 76% specificity (AUC = 0.80). Conclusion PAT is associated with measures of cardiometabolic risk and these associations are stronger in women compared to men. PAT could serve as a biomarker for opportunistic screening for cardiometabolic risk in patients undergoing chest CT.

Towards reference values of pericoronary adipose tissue attenuation: impact of coronary artery and tube voltage in coronary computed tomography angiography

“…Sex-related differences in PCAT MA could be caused by several factors. Men have a higher amount of EAT than women [34,35], related to cardiovascular risk. There are sex-related differences in the regulation mechanism of pericardial adipokines [36] and in the physiological mechanism of adipose tissue [37].…”

Pericardial fat and its influence on cardiac diastolic function

“…To assess the independent association of PF and diastolic function parameters in these 254 patients, linear regression analysis was performed with either LAVI or e′ septal or e′ lateral or TR as the dependent variable. These models were adjusted for BMI, age, sex, and their interaction terms with PF, since it is known that these parameters are strongly associated with PF [9,35,36]. Results of the linear regression analysis are presented as regression coefficient with 95% confidence interval (95% CI).…”

Pericardial fat and its influence on cardiac diastolic function

“…To assess the independent association of PF and diastolic function parameters in these 254 patients, linear regression analysis was performed with either LAVI or e' septal or e' lateral or TR as the dependent variable. These models were adjusted for BMI, age, and sex, since it is known that these parameters are strongly associated with PF (9,29,30). Results of the linear regression analysis are presented as regression coefficient with 95% confidence interval (95% CI).…”