Fat around the heart— known as pericardial fat— may be a better predictor of future heart disease than either body mass index (BMI) or waist circumference, a new study suggests.
The study, published in the September issue of the American Journal of Clinical Nutrition (Am J Clin Nutr 2009;90:499-504), was conducted by US researchers led by Dr Jingzhong Ding (Wake Forest University School of Medicine, Winston-Salem, North Carolina, US).
They conducted a case-cohort study in 998 individuals taking part in the Multi-Ethnic Study of Atherosclerosis (MESA), who had no history of cardiovascular disease. The volume of pericardial fat was measured using cardiac CT scans performed at baseline in the MESA trial.
Of the 998 individuals, 26 developed coronary heart disease during the five year follow-up. In unadjusted analyses, pericardial fat, but not body mass index, was associated with the risk of coronary heart disease (CHD). Waist circumference was marginally associated with CHD risk. The relation between pericardial fat and CHD remained significant after further adjustment for body mass index and other cardiovascular disease risk factors.
“Our data support the idea that pericardial fat is a better predictor of incident CHD than are more general measures of adiposity (e.g. BMI or waist circumference),” the authors say. However, they note that routine CT scans are not feasible for mass screenings at the present time, but the echocardiographic measurement of pericardial fat “has potential for CHD risk stratification”.