부산대학교 도서관

Background:Although obstructive sleep apnea (OSA) is frequently associated with obesity, body mass index (BMI) is not a good measure of body adiposity. Epicardial adipose tissue (EAT) is a metabolically active fat depot, and its thickness has been shown to correlate with OSA. Computed tomography permits quantification of EAT volume and density. Lower epicardial fat density associates with the presence of inflammatory white EAT. No studies have evaluated the association between EAT parameters with coronary plaque burden in patients with OSA.Aim:To compare the association between OSA severity with EAT volume, EAT density and BMIMethods:Participants underwent clinically indicated overnight polysomnography, and the degree of OSA was determined by the apnoea/hypopnea index (AHI), and severe OSA was defined as AHI > 30. Participants also underwent clinically indicated coronary computed tomography angiography (CTCA). EAT volume and Leaman scores were quantified on CTCA, and significant coronary plaque burden was defined as Leaman score > 8.3.Results:Participants (n = 71, age 59.7 years, BMI 32.6 kg/m2, 24% female, 31% severe OSA) had a median EAT volume 98 mL and Leaman score 6.57. EAT volume correlated with AHI (r = 0.29; p = 0.01), BMI (r = 0.29, p = 0.01) and Leaman score (r = 0.32; p = 0.01). EAT mean density correlated with Leaman score (r = -0.35; p = 0.02) but not AHI (p = 0.90) or BMI (p = 0.80). AHI correlated with EAT volume (r = 0.29; p = 0.01) and BMI (r = 0.20, p = 0.03) but not mean EAT density (p = 0.90), age (p = 0.94) or gender (p = 0.27). On multivariate linear regression, EAT volume continued to independently associate with AHI (p = 0.01). Patients with severe OSA had higher EAT volume (116 mL vs. 86 mL, p = 0.05) compared to those without severe OSA. On multivariate analysis, EAT volume independently associated with the presence of severe OSA (p = 0.01).Conclusion:EAT volume associated with OSA severity and may be a potential marker of cardiovascular risk in these patients.