Gender difference in the relationship between epicardial adipose tissue and central obesity

Body fat distribution is closely related to cardiovascular disease than the amount of total body fat itself. The epicardial adipose tissue (EAT) measured by transthoracic echocardiography represents central obesity. We hypothesized that the gender affected the link between EAT thickness and body fat distribution. We measured EAT thickness using transthoracic echocardiography and total body fat and regional body fat distribution using dual-energy X-ray absorptiometry (DXA) in 390 patients (250 males, 59 ± 11 year-old). The EAT thickness was measured on the free wall of the right ventricle at the end of the diastole on parasternal long-axis view of echocardiography. The median and mean EAT thickness of 390 patients were 4.0 mm and 4.2 ± 1.2 mm, respectively. The mean EAT thickness revealed positive correlation with truncal fat mass to total body fat mass ratio (FMtrunk/FMtotal, R = 0.291, P = .024). Subgroup analysis categorized by gender demonstrated the female group has stronger correlation of EAT thickness with fat distribution than the male group (male: R = 0.174, P = .006, female: R = 0.378, P < .001). EAT thickness is closely related to body fat distribution. Females showed a more significant correlation between EAT thickness and central fat accumulation than males. EAT thickness might be considered as a relevant parameter of central obesity, especially in females.