Research Article
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Regional fat distribution as a predictor of carotid atherosclerosis: insights from mediastinal and cervical fat analysis

Year 2025, Volume: 2 Issue: 1, 32 - 37, 15.02.2025
https://doi.org/10.70058/cjm.1540945

Abstract

Objective
Atherosclerosis is a leading cause of cardiovascular diseases such as myocardial infarction and stroke. Obesity, particularly regional fat distribution, is known to play a significant role in the pathogenesis of atherosclerosis. The aim of our study is to investigate the relationship between the anterior mediastinal fat tissue area, posterior cervical subcutaneous fat tissue thickness, and the presence of carotid plaque.
Methods
This retrospective study included 273 patients who underwent carotid CT angiography between 2021 and 2023. Patients under 18 years, with malignancy, or with inadequate image quality were excluded. Anterior mediastinal fat tissue area was measured manually on axial CT images, and posterior cervical subcutaneous fat thickness was measured on sagittal images. Statistical analyses included the Mann-Whitney U test, Spearman's correlation, and logistic regression.
Results
There was a significant positive correlation between mediastinal fat area and carotid plaque presence (rs = 0.3417, p < 0.05). The optimal cut-off value for mediastinal fat area to detect carotid plaque was 575 mm², with 78.79% sensitivity and 62.67% specificity. No significant correlation was found between cervical fat thickness and carotid plaque presence.
Conclusion
The anterior mediastinal fat tissue area is a moderate predictor of carotid plaque presence and can be easily measured during routine CT scans. This measurement may help identify patients at risk of atherosclerosis and guide further diagnostic evaluations.

Ethical Statement

Ethics committee approval was obtained from Health Sciences University Umraniye Training and Research Hospital Clinical Research Ethics Committee on 02/11/2023(APPROVAL CODE: B.10.1.TKH.4.34.H.GP.0.01/210)

References

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  • World Health Organization. Cardiovascular diseases. Available from: https://www.who.int/health-topics/ cardiovasculardiseases#tab=tab_1
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  • Jin X, Qiu T, Li L, et al. Pathophysiology of obesity and its associated diseases. Acta Pharm Sin B. 2023. doi:10.1016/j. apsb.2023.01.012.
  • Herold J, Kalucka J. Angiogenesis in AdiposeTissue: The Interplay Between Adipose and Endothelial Cells. Front Physiol. 2021;11:624903. Published 2021 Feb 9. doi:10.3389/ fphys.2020.624903.
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  • Bekin Sarıkaya PZ, Tekeli Kunt A. Mediastinal adipose tissue and aortic measurements in thorax CT: is it related to atherosclerosis? J Med Palliat Care. 2023;4(2):79-83.
  • Cademartiri F, Balestrieri A, Cau R, et al. Insight from imaging on plaque vulnerability: similarities and differences between coronary and carotid arteries-implications for systemic therapies. Cardiovasc Diagn Ther. 2020;10 (4):1150-1162. doi:10.21037/ cdt-20-528.
  • Piche JD, Rodoni B, Muralidharan A, et al. Investigating the Association of Patient Body Mass Index With Posterior Subcutaneous Fat Thickness in the Cervical Spine: A Retrospective Radiographic Study. Cureus. 2023;15(2):e34739. Published 2023 Feb 7.
  • Tsaban G, Bilitzky-Kopit A, Yaskolka Meir A, et al. The Effect of Weight-Loss Interventions on Cervical and Chin Subcutaneous Fat Depots; the CENTRAL Randomized Controlled Trial. Nutrients. 2021;13(11):3827. Published 2021 Oct 27.
  • Gruzdeva O, Borodkina D, Uchasova E, Dyleva Y, Barbarash O. Localization of fat depots and cardiovascular risk. Lipids Health Dis. 2018;17(1):218. Published 2018 Sep 15.

Karotid aterosklerozunun bir prediktörü olarak bölgesel yağ dağılımı: mediastinal ve servikal yağ analizinden elde edilen bulgular

Year 2025, Volume: 2 Issue: 1, 32 - 37, 15.02.2025
https://doi.org/10.70058/cjm.1540945

Abstract

References

  • Pahwa R, Jialal I. Atherosclerosis. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2023 Aug 8.
  • World Health Organization. Cardiovascular diseases. Available from: https://www.who.int/health-topics/ cardiovasculardiseases#tab=tab_1
  • Fan J, Watanabe T. Atherosclerosis: Known and unknown. Pathol Int. 2022;72(3):151-160.
  • Powell-Wiley TM, Poirier P, Burke LE, et al. Obesity and Cardiovascular Disease: A Scientific Statement From the American Heart Association. Circulation. 2021;143(21):e984-e1010. doi:10.1161/CIR.0000000000000973.
  • Cesaro A, De Michele G, Fimiani F, et al. Visceral adipose tissue and residual cardiovascular risk: a pathological link and new therapeutic options. Front Cardiovasc Med. 2023;10:1187735. Published 2023 Jul 27. doi:10.3389/fcvm.2023.1187735.
  • Emir SN, Emir S, Dereli Bulut SS, Basat S. Understanding the significance of adipose tissue in the inflammatory response to COVID-19. ObesMed. 2024;47:100538. doi:10.1016/j. obmed.2024.100538.
  • Braescu L, Gaspar M, Buriman D, et al. The Role and Implications of Epicardial Fat in Coronary Atherosclerotic Disease. J Clin Med. 2022;11(16):4718. Published 2022 Aug 12. doi:10.3390/ jcm11164718.
  • Calcaterra V, Cena H, Garella V, et al. Assessment of Epicardial Fat in Children: Its Role as a Cardiovascular Risk Factor and How It Is Influenced by Lifestyle Habits. Nutrients. 2024;16(3):420. doi:10.3390/nu16030420.
  • Rosito GA, Massaro JM, Hoffmann U, et al. Pericardial fat, visceral abdominal fat, cardiovascular disease risk factors, and vascular calcification in a community-based sample: theFramingham Heart Study. Circulation. 2008;117(5):605-613.
  • Al-Mansoori L, Al-Jaber H, Prince MS, Elrayess MA. Role of Inflammatory Cytokines, Growth Factors and Adipokines in Adipogenesis and Insulin Resistance. Inflammation. 2022;45(1):31-44. doi:10.1007/s10753-021-01559-z.
  • Grant EG, Benson CB, Moneta GL, et al. Carotid artery stenosis: gray-scale and Doppler US diagnosis--Society of Radiologists in Ultrasound Consensus Conference. Radiology. 2003;229(2):340- 346.
  • Jin X, Qiu T, Li L, et al. Pathophysiology of obesity and its associated diseases. Acta Pharm Sin B. 2023. doi:10.1016/j. apsb.2023.01.012.
  • Herold J, Kalucka J. Angiogenesis in AdiposeTissue: The Interplay Between Adipose and Endothelial Cells. Front Physiol. 2021;11:624903. Published 2021 Feb 9. doi:10.3389/ fphys.2020.624903.
  • Iacobellis G, Corradi D, Sharma AM. Epicardial adipose tissue: anatomic, biomolecular and clinical relationships with the heart. Nat Clin Pract Cardiovasc Med. 2005;2(10):536-543. doi:10.1038/ncpcardio0319.
  • Bekin Sarıkaya PZ, Tekeli Kunt A. Mediastinal adipose tissue and aortic measurements in thorax CT: is it related to atherosclerosis? J Med Palliat Care. 2023;4(2):79-83.
  • Cademartiri F, Balestrieri A, Cau R, et al. Insight from imaging on plaque vulnerability: similarities and differences between coronary and carotid arteries-implications for systemic therapies. Cardiovasc Diagn Ther. 2020;10 (4):1150-1162. doi:10.21037/ cdt-20-528.
  • Piche JD, Rodoni B, Muralidharan A, et al. Investigating the Association of Patient Body Mass Index With Posterior Subcutaneous Fat Thickness in the Cervical Spine: A Retrospective Radiographic Study. Cureus. 2023;15(2):e34739. Published 2023 Feb 7.
  • Tsaban G, Bilitzky-Kopit A, Yaskolka Meir A, et al. The Effect of Weight-Loss Interventions on Cervical and Chin Subcutaneous Fat Depots; the CENTRAL Randomized Controlled Trial. Nutrients. 2021;13(11):3827. Published 2021 Oct 27.
  • Gruzdeva O, Borodkina D, Uchasova E, Dyleva Y, Barbarash O. Localization of fat depots and cardiovascular risk. Lipids Health Dis. 2018;17(1):218. Published 2018 Sep 15.
There are 19 citations in total.

Details

Primary Language English
Subjects Diagnostic Radiography
Journal Section Research Articles
Authors

Sevde Nur Emir 0000-0001-5749-8776

Servet Emir 0000-0003-0342-6536

Publication Date February 15, 2025
Submission Date August 30, 2024
Acceptance Date October 22, 2024
Published in Issue Year 2025 Volume: 2 Issue: 1

Cite

Vancouver Emir SN, Emir S. Regional fat distribution as a predictor of carotid atherosclerosis: insights from mediastinal and cervical fat analysis. Cerasus J Med. 2025;2(1):32-7.