Atherogenic Index of Plasma Associates With Epicardial Adipose Tissue Volume on Coronary Computed Tomography Angiography

Abstract

The atherogenic index of plasma (AIP) is a novel biomarker of atherogenic dyslipidaemia (AD) but its relationship with cardiac adipose tissue depots—epicardial adipose tissue (EAT) and pericoronary adipose tissue (PCAT)—is unknown. We aimed to assess the association of AD with cardiac adipose tissue parameters quantified on coronary computed tomography angiography (CCTA). We studied 161 patients who underwent CCTA between 2008 and 2011 (age 59.0±14.0 yrs). AD was defined as triglyceride (TG)>1.7mmol/L and HDL<1.0mmol/L (n=34). AIP was defined as the base 10 logarithmic ratio of TG to HDL. Plaque burden was assessed using the CT-Leaman score (CT-LeSc). We studied volume and attenuation of EAT (EAT-v and EAT-a) and PCAT (PCAT-v and PCAT-a) on CCTA using semi-automated software. Patients with AD had higher PCAT-v (p=0.042) and EAT-v (p=0.041). AIP was associated with EAT-v (p=0.006), type II diabetes (p=0.009) and male sex (p<0.001), and correlated with CT-LeSc (p=0.040). EAT-v progressively increased across quartiles of AIP (p=0.029). On multivariable analysis, AIP was associated with EAT-v≥52.3cm3, age, male sex and type II diabetes when corrected for traditional risk factors and plaque burden. EAT-v≥52.3cm3 was associated with AIP, age and obesity when corrected for traditional risk factors and plaque burden. AIP is associated with increased EAT volume, but not PCAT-a, after multivariable adjustment. These findings indicate AIP is associated with adverse adipose tissue changes which may increase coronary risk.