Grasa epicárdica y su asociación con el HOMA-IR y el grosor íntima-media carotídeo

Background Epicardial fat is currently considered a real endocrine organ that can be easily determined by echocardiography, emerging as a novel parameter for the estimation of cardiometabolic risk. Objective To establish the association between epicardial fat, insulin resistance and carotid intima-media thickness. Methods The Instituto Nacional de Endocrinologia and the Instituto Nacional de Cardiologia y Cirugia Cardiovascular conducted a cross-sectional study on 239 patients with suspected disorders of carbohydrate metabolism. Clinical variables (age, gender, smoking habits, systolic and diastolic blood pressure), anthropometric measurements (waist circumference and body mass index), biochemical determinations (blood glucose, total cholesterol, HDL-C, LDL-C, triglycerides, fasting insulin level and HOMA-IR) and ultrasound measurements (carotid intima-media thickness) were assessed. Results A significant and independent association was found between blood glucose, epicardial fat and waist circumference, in that order, and HOMA-IR >2.6. Epicardial fat also showed a positive and significant correlation with fasting insulin levels (r=0.536; p=0.0001) and HOMA-IR (r=0.512; p=0.001). The correlation between epicardial fat and carotid intima-media thickness was greater in insulin resistant patients (r=0.523; p=0.0001), compared to patients with HOMA-IR 2.6. Introduccion La grasa epicardica se considera actualmente como un verdadero organo endocrino y su determinacion ecocardiografica ha surgido como un nuevo parametro de facil adquisicion en la evaluacion del riesgo cardiometabolico. Objetivo Determinar la asociacion entre la grasa epicardica, la presencia de insulinorresistencia y el grosor intima-media carotideo. Material y metodos Se realizo un estudio transversal en 239 pacientes con sospecha de trastornos en el metabolismo de los carbohidratos en colaboracion entre el Instituto Nacional de Endocrinologia y el Instituto Nacional de Cardiologia y Cirugia Cardiovascular. Se incluyeron variables clinicas (edad, sexo, antecedentes de tabaquismo, presion arterial sistol