Epicardial fat thickness: Relationship with plasma visfatin and plasminogen activator inhibitor-1 levels in visceral obesity

Alexis E. Malavazos, Federica Ermetici, Emanuele Cereda, Calin Coman, Massimo Locati, Lelio Morricone, Massimiliano M. Corsi, Bruno Ambrosi

Research output: Contribution to journalArticlepeer-review


Background and aim: Epicardial fat (EF), a true visceral adipose tissue (VAT) deposited around the heart, is considered as possible cardiovascular risk indicator, in view of its ability to produce and release several inflammatory adipo-cytokines. It is still not known whether increased cardiac adiposity is related to increased inflammatory adipo-cytokines in obesity. The aim of this study was to evaluate whether echocardiographic EF thickness, an indicator of cardiac adiposity, is related to circulating levels of inflammatory adipo-cytokines such as visfatin and plasminogen activator inhibitor-1 (PAI-1) in visceral obesity. Methods and results: EF thickness (measured by echocardiography), visfatin, PAI-1 antigen and some inflammatory markers were studied in 42 women, 27 of them severely obese (OB) (BMI 43.5 ± 4.8 kg/m2) but with no apparent complications, and 15 normal-weight controls. Abdominal VAT in the OB was assessed by computed tomography. OB had thicker EF and higher visfatin and PAI-1 antigen concentrations than controls (P <0.0001). EF thickness, log-visfatin and log-PAI-1 antigen concentrations directly correlated with VAT (P <0.0001). Log-visfatin and log-PAI-1 antigen were correlated with EF thickness even after adjusting for indices of fat distribution (P <0.01 and P <0.001 respectively). Moreover, when dividing OB on the basis of median EF thickness, women with greater EF thickness had more VAT and higher adipo-cytokine concentrations and inflammatory markers. Conclusions: This study suggests that EF thickness, an indicator of cardiac adiposity, may be significantly related to inflammatory adipo-cytokines in visceral-obese patients. This suggests EF might be used as an easy and reliable marker of visceral adiposity and inflammation and as a cardiovascular risk indicator.

Original languageEnglish
Pages (from-to)523-530
Number of pages8
JournalNutrition, Metabolism and Cardiovascular Diseases
Issue number8
Publication statusPublished - Oct 2008


  • Echocardiography
  • Epicardial fat
  • Inflammation
  • Plasminogen activator inhibitor-1
  • Visceral adipose tissue
  • Visfatin

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Medicine (miscellaneous)
  • Endocrinology, Diabetes and Metabolism
  • Nutrition and Dietetics


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