Abstract：
OBJECTIVE: To assess coronary inflammation by measuring the volume and density of the epicardial adipose tissue (EAT), perivascular fat attenuation index (FAI) and coronary plaque burden in patients with Cushing\'s syndrome (CS) based on coronary computed tomography angiography (CCTA).
METHODS: This study included 29 patients with CS and 58 matched patients without CS who underwent CCTA. The EAT volume, EAT density, FAI and coronary plaque burden were measured. The high-risk plaque (HRP) was also evaluated. CS duration from diagnosis, 24-h urinary free cortisol (UFC), and abdominal visceral adipose tissue volume (VAT) of CS patients were recorded.
RESULTS: The CS group had higher EAT volume (146.9 [115.4, 184.2] vs. 119.6 [69.0, 147.1] mL, P = 0.006), lower EAT density (- 78.79 ± 5.89 vs. - 75.98 ± 6.03 HU, P = 0.042), lower FAI (- 84.0 ± 8.92 vs. - 79.40 ± 10.04 HU, P = 0.038), higher total plaque volume (88.81 [36.26, 522.5] vs. 44.45 [0, 198.16] mL, P = 0.010) and more HRP plaques (7.3% vs. 1.8%, P = 0.026) than the controls. The multivariate analysis suggested that CS itself (β [95% CI], 29.233 [10.436, 48.03], P = 0.014), CS duration (β [95% CI], 0.176 [0.185, 4.242], P = 0.033), and UFC (β [95% CI], 0.197 [1.803, 19.719], P = 0.019) were strongly associated with EAT volume but not EAT density, and EAT volume (β [95% CI] - 0.037[- 0.058, - 0.016], P = 0.001) not CS was strongly associated with EAT density. EAT volume, FAI and plaque burden increased (all P < 0.05) in 6 CS patients with follow-up CCTA. The EAT volume had a moderate correlation with abdominal VAT volume (r = 0.526, P = 0.008) in CS patients.
CONCLUSIONS: Patients with CS have higher EAT volume and coronary plaque burden but less inflammation as detected by EAT density and FAI. The EAT density is associated with EAT volume but not CS itself.
METHODS: This study included 29 patients with CS and 58 matched patients without CS who underwent CCTA. The EAT volume, EAT density, FAI and coronary plaque burden were measured. The high-risk plaque (HRP) was also evaluated. CS duration from diagnosis, 24-h urinary free cortisol (UFC), and abdominal visceral adipose tissue volume (VAT) of CS patients were recorded.
RESULTS: The CS group had higher EAT volume (146.9 [115.4, 184.2] vs. 119.6 [69.0, 147.1] mL, P = 0.006), lower EAT density (- 78.79 ± 5.89 vs. - 75.98 ± 6.03 HU, P = 0.042), lower FAI (- 84.0 ± 8.92 vs. - 79.40 ± 10.04 HU, P = 0.038), higher total plaque volume (88.81 [36.26, 522.5] vs. 44.45 [0, 198.16] mL, P = 0.010) and more HRP plaques (7.3% vs. 1.8%, P = 0.026) than the controls. The multivariate analysis suggested that CS itself (β [95% CI], 29.233 [10.436, 48.03], P = 0.014), CS duration (β [95% CI], 0.176 [0.185, 4.242], P = 0.033), and UFC (β [95% CI], 0.197 [1.803, 19.719], P = 0.019) were strongly associated with EAT volume but not EAT density, and EAT volume (β [95% CI] - 0.037[- 0.058, - 0.016], P = 0.001) not CS was strongly associated with EAT density. EAT volume, FAI and plaque burden increased (all P < 0.05) in 6 CS patients with follow-up CCTA. The EAT volume had a moderate correlation with abdominal VAT volume (r = 0.526, P = 0.008) in CS patients.
CONCLUSIONS: Patients with CS have higher EAT volume and coronary plaque burden but less inflammation as detected by EAT density and FAI. The EAT density is associated with EAT volume but not CS itself.
摘要：
目的：通过测量心外膜脂肪组织（EAT）的体积和密度来评估冠状动脉炎症，基于冠状动脉CT血管造影（CCTA）的库欣综合征（CS）患者的血管周脂肪衰减指数（FAI）和冠状动脉斑块负荷。
方法：本研究包括29例CS患者和58例非CS患者，均接受CCTA。EAT音量，进食密度,测量FAI和冠状动脉斑块负荷。还评估了高危斑块（HRP）。从诊断开始的CS持续时间，24小时尿游离皮质醇（UFC），记录CS患者的腹部内脏脂肪组织体积（VAT）。
结果：CS组的进食量较高（146.9[115.4，184.2]与119.6[69.0,147.1]毫升,P=0.006),较低的EAT密度（-78.79±5.89vs.-75.98±6.03HU，P=0.042),较低的FAI（-84.0±8.92vs.-79.40±10.04HU，P=0.038),更高的总斑块体积（88.81[36.26,522.5]vs.44.45[0,198.16]毫升,P=0.010）和更多的HRP斑块（7.3%vs.1.8%,P=0.026）比对照组。多变量分析表明CS本身(β[95%CI]，29.233[10.436,48.03],P=0.014),CS持续时间（β[95%CI]，0.176[0.185,4.242],P=0.033),和UFC(β[95%CI]，0.197[1.803,19.719],P=0.019)与进食量密切相关，但与进食密度无关，和进食量（β[95%CI]-0.037[-0.058，-0.016]，P=0.001）非CS与EAT密度密切相关。EAT音量,随访CCTA6例CS患者FAI和斑块负荷均增加(P均<0.05)。CS患者的EAT量与腹部VAT量呈中度相关（r=0.526，P=0.008）。
结论：根据EAT密度和FAI检测，CS患者的EAT体积和冠状动脉斑块负荷较高，但炎症反应较少。EAT密度与EAT体积相关，但与CS本身无关。
方法：本研究包括29例CS患者和58例非CS患者，均接受CCTA。EAT音量，进食密度,测量FAI和冠状动脉斑块负荷。还评估了高危斑块（HRP）。从诊断开始的CS持续时间，24小时尿游离皮质醇（UFC），记录CS患者的腹部内脏脂肪组织体积（VAT）。
结果：CS组的进食量较高（146.9[115.4，184.2]与119.6[69.0,147.1]毫升,P=0.006),较低的EAT密度（-78.79±5.89vs.-75.98±6.03HU，P=0.042),较低的FAI（-84.0±8.92vs.-79.40±10.04HU，P=0.038),更高的总斑块体积（88.81[36.26,522.5]vs.44.45[0,198.16]毫升,P=0.010）和更多的HRP斑块（7.3%vs.1.8%,P=0.026）比对照组。多变量分析表明CS本身(β[95%CI]，29.233[10.436,48.03],P=0.014),CS持续时间（β[95%CI]，0.176[0.185,4.242],P=0.033),和UFC(β[95%CI]，0.197[1.803,19.719],P=0.019)与进食量密切相关，但与进食密度无关，和进食量（β[95%CI]-0.037[-0.058，-0.016]，P=0.001）非CS与EAT密度密切相关。EAT音量,随访CCTA6例CS患者FAI和斑块负荷均增加(P均<0.05)。CS患者的EAT量与腹部VAT量呈中度相关（r=0.526，P=0.008）。
结论：根据EAT密度和FAI检测，CS患者的EAT体积和冠状动脉斑块负荷较高，但炎症反应较少。EAT密度与EAT体积相关，但与CS本身无关。
