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Association of epicardial fat thickness with clinical and polysomnographic parameters in non-obese obstructive sleep apnoea patients

  • S Derin (a1), I Altun (a2), S Koseoglu (a1), C Sahin (a3), M Yilmaz (a4), F Akin (a2) and M Sahan (a1)...

This study aimed to investigate the relationship of epicardial fat thickness with severity of obstructive sleep apnoea, and clinical and polysomnographic parameters, and to determine independent predictors for epicardial fat thickness.


A total of 84 patients with a body mass index of less than 30 kg/m2 and suspected sleep-disordered breathing were included in the study. The correlations of epicardial fat thickness with polysomnographic and clinical data, and severity of obstructive sleep apnoea, were investigated.


Mean epicardial fat thickness was 3.75 ± 1.07 mm in the study group (n = 62) and 2.97 ± 0.62 mm in the control group (n = 22) (p < 0.001). There were significant positive correlations between epicardial fat thickness and: apnoea/hypopnoea index, oxygen desaturation index 3 and minimum oxygen saturation, as well as with age, body mass index, and neck and waist circumferences.


Non-obese obstructive sleep apnoea patients have thicker epicardial fat compared to controls. Oxygen desaturation index 3 has a strong correlation with epicardial fat thickness and is an independent predictor of it.

Corresponding author
Author for correspondence: Dr Serhan Derin, Tıp Fakültesi, Muğla Sıtkı Koçman Üniversitesi, Haluk Ozsoy Street, Orhaniye District, 48000 Muğla, Turkey E-mail:
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Presented at the 12th National Congress of Rhinology, 21–24 April 2016, Antalya, Turkey.

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1Sengul, C, Ozveren, O. Epicardial adipose tissue: a review of physiology, pathophysiology, and clinical applications. Anadolu Kardiyol Derg 2013;13:261–5.
2Torres, T, Bettencourt, N, Mendonça, D, Vasconcelos, C, Gama, V, Silva, BM et al. Epicardial adipose tissue and coronary artery calcification in psoriasis patients. J Eur Acad Dermatol Venereol 2015;29:270–7.
3Mazurek, T, Zhang, L, Zalewski, A, Mannion, JD, Diehl, JT, Arafat, H et al. Human epicardial adipose tissue is a source of inflammatory mediators. Circulation 2003;108:2460–6.
4Gollasch, M, Dubrovska, G. Paracrine role for periadventitial adipose tissue in the regulation of arterial tone. Trends Pharmacol Sci 2004;25:647–53.
5Hajsadeghi, F, Nabavi, V, Bhandari, A, Choi, A, Vincent, H, Flores, F et al. Increased epicardial adipose tissue is associated with coronary artery disease and major adverse cardiovascular events. Atherosclerosis 2014;237:486–9.
6Pierdomenico, SD, Pierdomenico, AM, Cuccurullo, F, Iacobellis, G. Meta-analysis of the relation of echocardiographic epicardial adipose tissue thickness and the metabolic syndrome. Am J Cardiol 2013;111:73–8.
7Guilleminault, C, Tilkian, A, Dement, WC. The sleep apnea syndromes. Annu Rev Med 1976;27:465–84.
8Young, T, Palta, M, Dempsey, J, Skatrud, J, Weber, S, Badr, S. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med 1993;328:1230–5.
9Kent, BD, Ryan, S, McNicholas, WT. Obstructive sleep apnea and inflammation: relationship to cardiovascular co-morbidity. Respir Physiol Neurobiol 2011;178:475–81.
10Ryan, S, McNicholas, WT. Inflammatory cardiovascular risk markers in obstructive sleep apnoea syndrome. Cardiovasc Hematol Agents Med Chem 2009;7:7681.
11Ryan, S, Taylor, CT, McNicholas, WT. Systemic inflammation: a key factor in the pathogenesis of cardiovascular complications in obstructive sleep apnoea syndrome? Thorax 2009;64:631–6.
12Mariani, S, Fiore, D, Barbaro, G, Basciani, S, Saponara, M, D'Arcangelo, E et al. Association of epicardial fat thickness with the severity of obstructive sleep apnea in obese patients. Int J Cardiol 2013;167:2244–9.
13Lubrano, C, Saponara, M, Barbaro, G, Specchia, P, Addessi, E, Costantini, D et al. Relationships between body fat distribution, epicardial fat and obstructive sleep apnea in obese patients with and without metabolic syndrome. PLoS One 2012;7:e47059.
14Akilli, H, Kayrak, M, Bekci, TT, Erdogan, , Aribas, A, Yildirim, O et al. Gender-related changes of the epicardial fat thickness and leptin in obstructive sleep apnea. Echocardiography 2014;31:411–19.
15Izci, B, Ardic, S, Firat, H, Sahin, A, Altinors, M, Karacan, I. Reliability and validity studies of the Turkish version of the Epworth Sleepiness Scale. Sleep Breath 2008;12:161–8.
16Berry, RB, Brooks, R, Gamaldo, CE, Harding, SM, Lloyd, RM, Marcus, CL et al. ; American Academy of Sleep Medicine. AASM Manual for the Scoring of Sleep and Associated Events: Rules, Terminology and Technical Specifications, Version 2.0.3. Darien, Illinois: American Academy of Sleep Medicine, 2014.
17Iacobellis, G, Willens, HJ. Echocardiographic epicardial fat: a review of research and clinical applications. J Am Soc Echocardiogr 2009;22:1311–19.
18Kim, SH, Chung, JH, Kwon, BJ, Song, SW, Choi, WS. The associations of epicardial adipose tissue with coronary artery disease and coronary atherosclerosis. Int Heart J 2014;55:197203.
19Akbas, EM, Hamur, H, Demirtas, L, Bakirci, EM, Ozcicek, A, Ozcicek, F et al. Predictors of epicardial adipose tissue in patients with type 2 diabetes mellitus. Diabetol Metab Syndr 2014;6:55.
20Nar, G, Inci, S, Aksan, G, Unal, OK, Nar, R, Soylu, K. The relationship between epicardial fat thickness and gestational diabetes mellitus. Diabetol Metab Syndr 2014;6:120.
21Mohar, DS, Salcedo, J, Hoang, KC, Kumar, S, Saremi, F, Erande, AS et al. Epicardial adipose tissue volume as a marker of coronary artery disease severity in patients with diabetes independent of coronary artery calcium: findings from the CTRAD study. Diabetes Res Clin Pract 2014;106:228–35.
22Fluchter, S, Haghi, D, Dinter, D, Heberlein, W, Kühl, HP, Neff, W et al. Volumetric assessment of epicardial adipose tissue with cardiovascular magnetic resonance imaging. Obesity (Silver Spring) 2007;15:870–8.
23Çetin, S, Vural, MG, Gündüz, H, Akdemir, R, Fırat, H. Epicardial fat thickness regression with continuous positive airway pressure therapy in patients with obstructive sleep apnea: assessment by two-dimensional echocardiography. Wien Klin Wochenschr 2016;128:187–92.
24Simsek, G, Haytoglu, S, Muluk, NB, Arikan, OK, Cortuk, M, Kiraz, K. Mean platelet volume decreases in adult patients with obstructive sleep apnea after uvulopalatal flap surgery. J Craniofac Surg 2015;26:2152–4.
25Kim, YS, Kim, SY, Park, DY, Wu, HW, Hwang, GS, Kim, HJ. Clinical implication of heart rate variability in obstructive sleep apnea syndrome patients. J Craniofac Surg 2015;26:1592–5.
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