الفهرس 
INTRODUCTION AND Aim Of The WorkOnly 14 pages are availabe for public view
 |  | from | 212 |  |  |
| | | from | 212 | | |
Abstract
Visceral obesity is recognized as an important risk factor for the development of the metabolic syndrome, including insulin resistance, diabetes, dyslipidemia and hypertension.
Epicardial adipose tissue is a true visceral fat deposited around the heart. Particularly on the free wall of the right ventricle and on the left ventricular apex and also around the atria. An experimental study showed that epicardial adipose tissue should be considered an important cardiovascular risk indicator. Recently, researchers have suggested that epicaridal adipose tissue measurement as a predictor of visceral adipose tissue. The aim of this study was to estimate the epicardial fat thickness measured by echocardiographic in MS subjects and to correlate the findings to clinical and laboratory variables of the metabolic syndrome and to insulin resistance as measured by HOMA-IR.We conducted this study on 60 patients with MS and 30 obese control and 30 lean individuals. History taking clinical examination and laboratory testing were done.The study showed significant difference increased in BMI, WC, lipid profile(TG,LDL,HDL) and HOMA-IR and decrease in HDL in MS patient versus control groups. HDL was negatively correlated with BMI, WC and LV mass so the less HDL the more BMI, WC and LV mass while TG was correlated with HOMA IR and RWT .So TG is linked to insulin resistance. Increaded cardiac dimensions was observed in MS patients in comparison to control groups including LVEDD, IVS, PW, RWT, LV mass, AO diameter and LA diameter. Which is associated with more cardiovascular risk. EAT thickness is significantly higher in MS patients even more than control obese rather than control lean. It showed significant positive correlation with anthropometric parameters(BMI and WC),laboratory investigations (HOMA IR and liver transaminases) and cardiac dimensions (RWT and LV mass) .EAT correlated negatively with HDL and E/A ratio. EAT thickness increased with increasing numbers of metabolic syndrome components . EAT was influenced by BMI,TG,HDL and HOMA IR and it’s thickness could be predicted from the following equation :
[(BMI*0.107) +(TG*0.014)+(HDL*-0.025)+(HOMA IR*1.02)]-2.33
Cut off value of EAT for at least 3 or more metabolic syndrome components is 7.1 mm, these metabolic syndrome components are (WC, BL. Pressure, lipid profile and glucose level)
Conclusion
• Epicardial adipose tissue (EAT) correlates with BMI, WC, lipid profile, HOMA IR and echocardiographic dimensions.
• Epicardial adipose tissue (EAT) is predictor for other cardiovascular risk factors including dyslipidemia, diastolic dysfunction and LVH.
• Measuring of epicardial fat should be included routinely during echocardiography as sensitive predictor for metabolic and cardiovascular risk.
• Presence of increased amount of epicardial fat should lead to search for the other components of metabolic syndrome especially lipid profile, diabetic screening and hypertension.
• EAT thickness increased with increasing numbers of metabolic syndrome components.
• Nation wide studies are recommended including large number of subject in multicenters of both sex for determining cut off values for epicardial fat as well as waist circumference among Egyptian.
• Further applications of echocardiographic epicardial fat measurements can be proposed a therapeutic target during weight loss intervention either pharmacologically or surgical