Novel predictor for metabolic syndrome: Para-aortic adipose tissue.

Background: Metabolic Syndrome (MetS) is an independent risk factor for cardiovascular disease. Perivascular fat depots not only serve as energy storage but also function as endocrine organs. Para-aortic adipose tissue (PAT), a perivascular local adipose tissue, has been suggested to play a role in obesity-mediated vascular disease, and has been associated with MetS components and measures of coronary and abdominal aortic calcification. PAT was previously described and examined using tomography and magnetic resonance imaging. This study aimed to describe the features of para-aortic adipose tissue measured echocardiographically in individuals with MetS.

Methods: Patients were divided into two groups according to their MetS status. The hypoechoic space in front of the ascending aorta was considered a PAT on the parasternal long-axis view. Possible covariates for the regression analysis were determined using the DAGitty diagram.

Results: A total of 494 patients were enrolled in this study. The PAT was significantly higher in the MetS group [9.6 (6.1/10.6) vs. 6.1 (0.9/9) mm, p < 0.001]. Logistic regression analysis revealed that PAT (OR=2,15, p = 0,003) was significantly associated with MetS. 7.55 mm of PAT has a sensitivity of 65 % and specificity of 65 % [AUC = 0.675, p < 0.001, 95 % CI (0.623-0.726)] in predicting the presence of MetS.

Conclusions: Based on the measurements obtained using this newly described modality in transthoracic echocardiography, its relationship with MetS was determined. These results can guide clinicians in diagnosing MetS.