Behandling av hyperlipidemi vid prevention av kranskärlssjukdom

English summary. Kardiologi

För säkerhets skull en diskursanalys av debatten om den spanska medborgarsäkerhetslagen

In 2013 the conservative ruling party of Spain, Partido Popular, launched a draft to a new Citizen Security Law that after a year of critical debate was rammed by the congress. The opponents claim that the laws are undermining democratic rights such as freedom of assembly and freedom of speech. Partido Popular defends the laws with reference to security and safety while opponents claim that the underlying purpose is rather to criminalize new social protests that have emerged as a reply to the profound socioeconomic consequences of the Euro crisis. Theese social protests themselves adress problems of uncertainity, social insecurity and unsafety. The aim of this thesis is to use a combination of discourse theory and critical discourse analysis to examine the discursive conflict of the concepts security and safety within this debate. The study shows that there are three different competing discourses, one adressing democratic rights, one adressing crime and violence and one adressing welfare issues. It also shows that although Partido Popular makes little references to incidents of violence in social protests the concept violent people is central in their discourse making it possible to claim that the law is defending the rights of non violent citizens

A trip to Librobäck : a vision work about Librobäck in Uppsala

I nordvästra Uppsala ligger stadsdelen Librobäck. Stadsdelen håller på att omvandlas från ett industriområde till ett område med mycket bostäder. För att denna stadsdelsomvandling skall lyckas krävs också att områdets grönområden utvecklas. Med anledning av detta görs här ett gestaltningsarbete göras som visar hur en utvald grönyta kan utvecklas. Arbetet går ut på att inventera och analysera en plats för att ta fram en vision för hur området skall kunna utvecklas med hänsyn till platsens förutsättningar. Genom att inventera och analysera platsens olika delområden framkom vilka ytor som lämpas särskilt bra för att bli vistelseytor när platsen skall omgestaltas. Dessa ytor valdes i gestaltningen ut som vistelseytor med karaktärer, funktioner och storlekar, passande för respektive yta. Analysen visade även vilka ytor som har en negativ påverkan på platsen. I gestaltningen föreslås att dessa ytor skall döljas från stråk och vistelseytor, alternativt utvecklas. Innan gestaltningsprocessen startades lästes ett antal teorier om hur upplevelsevärden och naturvärden kan utvecklas i grönområden. Dessa underströk bland annat vikten av variation och flexibilitet, att göra ytor som kan passa så många som möjligt samt att ständigt bjuda på nya upplevelser när man rör sig i miljön. Andra viktiga aspekter som togs upp var att människor ofta föredrar välskötta miljöer samt olika typer av rumslighet. Med dessa teorier som bakgrund arbetades ett visionärt förslag fram. Förslaget följer ett koncept som i huvudsak går ut på att uppmärksamma det naturligt vackra som finns i området samt att tillgängliggöra fler ytor. Samtidigt finns också en vilja att varva de naturliga kvaliteter som finns med nya tillägg för att skapa en variationsrik miljö där besökaren kan uppleva många olika vyer och funktioner. Beskrivning av förslaget För att samspela med angränsande ytor och bli ett intressant och variationsrikt område så gjordes en gestaltning där olika delområden fick olika karaktärer. Dessa delområden skiljer sig både gällande funktioner och karaktärer men lyfter alla fram platsens befintliga kvaliteter på olika sätt. Intill de planerade bostäderna föreslås en mindre yta där anläggningsarbete och skötsel koncentreras. Här skall närheten till den meandrande bäcken uppmärksammas och området skall få en ordnad karaktär med stark rumlighet. Ytan är förhållandevis liten och föreslås bli områdets ”finpark”. Intill denna finpark kommer ytterligare en välskött yta anläggas, som de boende kan nyttja. För att ge ytan en flexibel användning föreslås här en gräsmatta samt en mindre mängd lekutrustning och möbler. I resterande delar av arbetsområdet föreslås skötselnivån vara låg och den friväxande vegetationen får ge variation till de mer välskötta områdena. På de ytor som föreslås ha låga skötselnivåer kommer de naturliga kvaliteterna lyftas fram. Där ravinen är mäktig föreslås naturnära vistelseytor där stråk slingrar sig fram bland områdets skira ängsytor. Finns möjlighet bör försök att skapa större områden med ängskaraktär göras genom att mer frekvent slå ytorna så att vallörten utrotas alternativt hålls nere. Ängsytorna ger karaktär åt arbetsområdet och kopplar samman gestaltningen med områdets tidigare namn ”Libroängen” Området ska omvandlas så mycket att det känns nytt och intressant. Med sina nya upplevelsevärden och goda kopplingar till närliggande grönområden och stadsdelar ska det fungera som stadsdelens hjärta. Ett hjärta som alla ska känna sig hemma i och som bjuder många funktioner och upplevelser i naturens tecken.Librobäck is a city district in northwestern Uppsala. As Uppsala grows, more central dwellings are needed and therefore, Librobäck is being transformed from an industrial area to a residential area. When the district is being transformed even the green areas have to develop. For this reason Uppsala municipality wants a study that shows how a selected green area in Librobäck can be designed to fit the new character of the district. The selected area is a narrow place with a meandering stream (Librobäcken), a gorge and natural areas with tall vegetation and a lot of trees and bushes along the stream. The municipality wants this natural area to be transformed to a neighbourhood park where the stream gets a more important role than today. Inventory and analysis To investigate how the area should be developed to become the district´s heart with more interesting experience values, there was an inventory and an analysis of the place. The purpose was to develop a vision for how the area could be developed to be naturally beautiful with resonable effort and cost. The inventory and the analysis included both site visits and literature studies. Literature studies To develop a vision with strong experience values some theories about experience values were studied. These theories told, among other things, that a place should have varied spatiality, give fascination, have good microclimate and additionally varied sigh lines. The theories also narrate that a place seems extra attractive it is well managed. These theories was the basis for the vision in this work. Besides this studies about why green spaces i good for the society were made. This study told that green space is good for both the public health, the social sustainability, the ecological sustainability and maybe even for the economy. Site visits When studying the topography, vegetation, climate, sound environment, spatiality and the plans for the district, it appeared which sites that had good potential to become “stay areas” and which sites that need to be developed or excluded from the area. Besides this, the inventory and the analysis showed that parts of the area are likely to be flooded within one hundred years. In order to avoid possible flooding devastating the area, parts that are likely to be flooded must consist of green space and not of buildings. The inventory is also told that the soil is prone to landslides. Due to this, the design shouldn’t include much transformation of the terrain in, or next to, the stream bed. The stream bed must, just like today, include both trees, bushes and herbaceous plants to decrease the landslide risk as much as possible. There is a landslide risk in all types of construction work which must be taken into account when the design proposal will be made. Other important information that the inventory and analysis gave can be summarized in seven points: 1. The topography and the meandering stream are naturally beautiful and unique qualities of the area. 2. The stream is inaccessible because of tall vegetation and since there are no paths where the stream can be seen from. 3. The site has healthy and big trees and bushes which should be preserved but the species diversity is poor. The poor species diversity makes the experience of the place a bit monotonous. 4. Since the area is almost exclusively made up by natural areas and has very low maintenance level, there is a small variation of experience and the site has few features. There are no gathering points or focus points and no natural places for visitors to stay in the area. There are also very few sight lines when walking through the area since the paths are completely straight. This makes the variation of experience even worse. 5. The area has both nice sites with gossamer meadows and sites with robust comfrey. The comfrey becomes brown and looks bad in the end of the summer but is hard to clear away. 6. There is no varied spatiality since there are no small separated rooms that are accessible in the area, only big rooms. 7. There are several barriers in the area. Due to this, the area feels discontinuous and better connections are needed between the different sites. Better connections to the green spaces and city district in the northwest of Uppsala are also necessary. This information gave good opportunities to make a credible and attractive design. Design proposal To solve the problem that the area has and to pay attention to the places’ strengths, a design that divides the area into smaller parts with different character is being proposed. By this proposal the area becomes more varied and there will be more experiences and features when visiting the area. Fine park At a place next to the stream where the views of the stream are good and the planned dwellings are close, a “fine park” is being proposed. By concentrating management and efforts to a smaller part of the area, a well maintained and tidy area can be created with relatively low costs. In this area the stream must be in focus. By creating a lawn with a wooden deck next to the water, and plant perennials and colorful bushes to frame the site, the area will get a unique neat place with water in focus. In order to let the water be an asset even when there are low water levels the water could be dammed next to this place. Lawn park To give the area a flexible spot where many can gather, an open lawn is being proposed. This should be next to the fine park in order to create an interesting and nice target point in the middle of the area. Since this area will be next to the planned dwellings even some play equipment could be appropriate to place in or next to this area. Natural areas with meadows With the intention to highlight the site’s natural qualities the areas with meadow will be preserved as they are. If there is money, the meadow character areas could be expanded. To do this, some attempts to mow down some parts of the areas with comfrey can be done. By more frequent mowing, other species haves better possibilities to grow up and give the area a stronger meadow character. Furthermore, the meadows can give spatiality to the area. Green passage Where the area is being divided by a barrier, a good overpass is needed. A good overpass not only means a safe passage but also means a nice and green passage that can bind the different parts of the area both physically and visually. Natural areas with targets points next to the gorge Where the stream bed is mighty and becomes a gorge, the topographic experience is unique and the nature experience is great. To use this quality in the design proposal, an accessible site where visitors can sit and admire the place should be constructed. Since there isn’t any plan to build dwellings next to this area today, there is no reason to change the character of this place. The place should, just like today, be a naturally beautiful place with low maintenance level. If the adjacent field next to this area will be turned into a residential area, a more park-like design can be appropriate. Until then there is no reason to propose more maintenance for this area. However, a path that makes the site accessible is needed and there should be easier to stay and enjoy the place. The different parts with different characters are being bound together by a concept. This concept consists of a willingness to highlight the qualities that already exist (especially the meadows, the water and the topographic expression), creating new and more varied experiences and raising the status of the area. Furthermore, the accessibility, the flexibility and the connection to paths nearby are important. Another interest is that all equipment (play equipment and furniture) should be of wood not to destroy the nature feeling. The result of this concept is for instance more paths, and more organic paths, to make a larger part of the area more accessible, both physically and visually. Additionally, more varied terrain is an important aspect while designing the area and that is why four different areas with a common concept have been proposed. Today the area is an anonymous green space. One part of the area is sandwiched between industries and the other part is inaccessible since it is completely separated from the areas footpaths. The described design proposal transforms the area from this anonymous character to a place to enjoy. A place where children can play and all people can gather, eat their lunch and above all, they can experience beautiful and varied nature with unique values. To see how the area can be developed to attract people in the neighborhood and from the rest of Uppsala, see illustrates on pages 60-67. Before the design process started, literature dealing with experience values and nature values were studied. The theories in the literature tell that varied spatiality, elements and experiences are very important when a green space shall provide good experience values. Since all of this was important when the design proposal was created, these theories serve as a support to the design proposal

Sepelvaltimoiden ja kaulavaltimoiden ahtautumisen vaaratekijät suomalaisilla sepelvaltimotutkimukseen lähetetyillä potilailla : verisuonten kvantitatiivinen varjoaine- ja ultraäänitutkimus

Background. Cardiovascular disease (CVD) remains the most serious threat to life and health in industrialized countries. Atherosclerosis is the main underlying pathology associated with CVD, in particular coronary artery disease (CAD), ischaemic stroke, and peripheral arterial disease. Risk factors play an important role in initiating and accelerating the complex process of atherosclerosis. Most studies of risk factors have focused on the presence or absence of clinically defined CVD. Less is known about the determinants of the severity and extent of atherosclerosis in symptomatic patients. Aims. To clarify the association between coronary and carotid artery atherosclerosis, and to study the determinants associated with these abnormalities with special regard to novel cardiovascular risk factors. Subjects and methods. Quantitative coronary angiography (QCA) and B-mode ultrasound were used to assess coronary and carotid artery atherosclerosis in 108 patients with clinically suspected CAD referred for elective coronary angiography. To evaluate anatomic severity and extent of CAD, several QCA parameters were incorporated into indexes. These measurements reflected CAD severity, extent, and overall atheroma burden and were calculated for the entire coronary tree and separately for different coronary segments (i.e., left main, proximal, mid, and distal segments). Maximum and mean intima-media thickness (IMT) values of carotid arteries were measured and expressed as mean aggregate values. Furthermore, the study design included extensive fasting blood samples, oral glucose tolerance test, and an oral fat-load test to be performed in each participant. Results. Maximum and mean IMT values were significantly correlated with CAD severity, extent, and atheroma burden. There was heterogeneity in associations between IMT and CAD indexes according to anatomical location of CAD. Maximum and mean IMT values, respectively, were correlated with QCA indexes for mid and distal segments but not with the proximal segments of coronary vessels. The values of paraoxonase-1 (PON1) activity and concentration, respectively, were lower in subjects with significant CAD and there was a significant relationship between PON1 activity and concentration and coronary atherosclerosis assessed by QCA. PON1 activity was a significant determinant of severity of CAD independently of HDL cholesterol. Neither PON1 activity nor concentration was associated with carotid IMT. The concentration of triglycerides (TGs), triglyceride-rich lipoproteins (TRLs), oxidized LDL (oxLDL), and the cholesterol content of remnant lipoprotein particle (RLP-C) were significantly increased at 6 hours after intake of an oral fatty meal as compared with fasting values. The mean peak size of LDL remained unchanged 6 hours after the test meal. The correlations between total TGs, TRLs, and RLP-C in fasting and postprandial state were highly significant. RLP-C correlated with oxLDL both in fasting and in fed state and inversely with LDL size. In multivariate analysis oxLDL was a determinant of severity and extent of CAD. Neither total TGs, TRLs, oxLDL, nor LDL size were linked to carotid atherosclerosis. Insulin resistance (IR) was associated with an increased severity and extent of coronary atherosclerosis and seemed to be a stronger predictor of coronary atherosclerosis in the distal parts of the coronary tree than in the proximal and mid parts. In the multivariate analysis IR was a significant predictor of the severity of CAD. IR did not correlate with carotid IMT. Maximum and mean carotid IMT were higher in patients with the apoE4 phenotype compared with subjects with the apoE3 phenotype. Likewise, patients with the apoE4 phenotype had a more severe and extensive CAD than individuals with the apoE3 phenotype. Conclusions. 1) There is an association between carotid IMT and the severity and extent of CAD. Carotid IMT seems to be a weaker predictor of coronary atherosclerosis in the proximal parts of the coronary tree than in the mid and distal parts. 2) PON1 activity has an important role in the pathogenesis of coronary atherosclerosis. More importantly, the study illustrates how the protective role of HDL could be modulated by its components such that equivalent serum concentrations of HDL cholesterol may not equate with an equivalent, potential protective capacity. 3) RLP-C in the fasting state is a good marker of postprandial TRLs. Circulating oxLDL increases in CAD patients postprandially. The highly significant positive correlation between postprandial TRLs and postprandial oxLDL suggests that the postprandial state creates oxidative stress. Our findings emphasize the fundamental role of LDL oxidation in the development of atherosclerosis even after inclusion of conventional CAD risk factors. 4) Disturbances in glucose metabolism are crucial in the pathogenesis of coronary atherosclerosis. In fact, subjects with IR are comparable with diabetic subjects in terms of severity and extent of CAD. 5) ApoE polymorphism is involved in the susceptibility to both carotid and coronary atherosclerosis.Valtimonkovettumataudin eli ateroskleroosin pohjalta syntyvät sydän- ja verisuonisairaudet (sepelvaltimotauti, aivoinfarkti, ääreissuoniston verisuonisairaus) ovat yleisimpiä kuolinsyitä teollistuneissa maissa. Ateroskleroosin kehityskaari on pitkä ja ennen oireiden ilmaantumista sitä ennustaa ja sen vaikeutta heijastaa lukuisa joukko vaaratekijöitä. Perinteiset vaaraa lisäävät tekijät, kuten kohonnut verenpaine, veren suuri kolesterolipitoisuus ja tupakointi tunnetaan hyvin. Ateroskleroosin kehittyminen eri osissa valtimopuustoa on kuitenkin monitekijäistä eivätkä perinteiset vaaratekijät kokonaan selitä kaikkien potilaiden sairastumista valtimotautiin. Tässä väitöskirjatyössä selvitettiin kaulavaltimoiden seinämämuutosten ja uusien mahdollisten vaaratekijöiden yhteyksiä sepelvaltimomuutoksiin 108:lla 35-75-vuotiaalla sepelvaltimotutkimukseen lähetetyllä potilaalla. Tutkimusmenetelminä käytettiin sepelvaltimoiden kvantitatiivista varjoainekuvausta ja kaulavaltimoiden seinämäpaksuuden mittausta ultraäänellä. Verinäytteistä tehtiin lipidi- ja lipoproteiinimäärityksiä. Jokaiselle tutkittavalle suoritettiin sekä sokerirasitus- että rasvakuormituskoe. Ensimmäisessä osajulkaisussa todettiin, että kaulavaltimoiden seinämämuutokset korreloivat sepelvaltimoiden muutoksiin hyvin johdonmukaisesti. Tutkimuslöydöksen valossa kaulavaltimoiden suurentunut seinämäpaksuus ennakoi sepelvaltimotaudin vaaraa ja vaikeusastetta. HDL-kolesteroli eli niin sanottu hyvä kolesteroli on ateroskleroosilta suojaava lipoproteiini, joka mm. pystyy estämään ja hidastamaan rasvan hapettumista verisuonissa. Tämä johtuu osittain HDL:n kuljettamasta entsyymistä, paraoksonaasi-1:stä (PON1). Toisessa osajulkaisussa havaittiin, että PON1 entsyymin pitoisuus ja aktiivisuus oli pienempi niillä potilailla joilla oli enemmän ateroskleroosia sepelvaltimoissa riippumatta HDL-kolesterolipitoisuudesta. Tulos viittaa siihen, ettei riskin tulkinta pelkän HDL-kolesterolipitoisuuden avulla ole välttämättä oikea, vaan myös HDL:n laadulla on merkitystä. Postprandiaaliseen eli aterianjälkeiseen tilaan liittyi lipoproteiinien jäännöspartikkelien lisääntyminen, mikä aiheutti oksidatiivista stressiä. Vaikka jäännöspartikkelien määrä ja triglyseridipitoisuus korreloivatkin keskenään, niillä ei ollut yhteyttä valtimomuutoksiin. Tämä puhuu postprandiaalisen tilan ja triglyseridipitoisuuden itsenäistä merkitystä vastaan valtimotaudin synnyssä, joskin monet mahdolliset tutkimustekniset tekijät on otettava huomioon. Sen sijaan aterianjälkeinen hapettuneen LDL-kolesterolin veripitoisuus (oksidoitu LDL) suureni ja tämä oli yhteydessä sepelvaltimomuutoksiin. Insuliiniresistenssi on keskeinen tyypin 2 (aikuistyypin) diabeteksen vaaratekijä. Insuliiniresistenssillä ja sepelvaltimomuutoksilla todettiin merkittävä yhteys. Insuliiniresistenssiin liittyi enemmän muutoksia sepelvaltimoiden ääreisosissa, mikä viittaa siihen, että jo diabetesta ennakoiva aineenvaihdunnan häiriö vaurioittaa laajalti valtimoita. Tämä löydös painottaa piilevänkin diabeteksen ja ns. metabolisen oireyhtymän merkitystä sepelvaltimotautipotilailla. Apolipoproteiini E (apoE) on kolesterolihiukkasten tärkeä komponentti. Väestössä esiintyy kolmea apoE:n alamuotoa (E2, E3 ja E4). Perimä määrää apoE:n tyypin. Viimeisessä osatyössä todettiin, että apoE:n alamuoto E4 näytti liittyvän selvästi pidemmälle edenneisiin valtimotautimuutoksiin E3-alamuotoon verrattuna sekä kaula- että sepelvaltimoissa. Tämä viittaa apoE4:n tärkeään merkitykseen ateroskleroosin synnyssä.Bestämning av faktorer som påverkar uppkomsten av ateroskleros i hjärtats och halsens blodkärl hos finländsk befolkning med klinisk misstanke på koronarsjukdom: undersökning av blodkärl med kontrastmedel och ultraljud. Hjärt- och kärlsjukdomar (koronarsjukdom, hjärninfarkt, perifer kärlsjukdom) är de vanligaste dödsorsakerna i västvärlden. De orsakas i huvudsak av ateroskleros dvs. förkalkning av blodkärl. I början av 1900-talet var den rådande uppfattningen att aterosklerotiska förändringar var en manifestation av åldrande och därmed opåverkbar. En mer positiv attityd råder i dag då många riskfaktorer såsom högt blodtryck, högt kolesterol och rökning har identifierats. Dessa riskfaktorer kan dock i sig inte fullt ut förklara uppkomsten och utvecklingen av ateroskleros. Ett stort antal faktorer är fortfarande okända. Med hjälp av ultraljud respektive kvantitativ koronarangiografi har vi undersökt aterosklerosens svårighetsgrad och omfattning i hjärtats och halsens blodkärl hos 108 patienter (35-75 år) som remitterats för koronarangiografi (= undersökning av hjärtats blodkärl med kontrastmedel) p.g.a. misstänkt koronarsjukdom. Resultaten från dessa kvantitativa mätningar har sedan korrelerats med potentiella riskfaktorer för ateroskleros. I denna studie fann vi ett positivt samband mellan ultraljudsmätt tjocklek av det innersta och mellersta lagret (den sk. intima-media tjockleken, IMT) i halsens kärlvägg och graden av koronarsjukdom. På basen av våra resultat kan vi konstatera att måttet på IMT kan vara en indikator för ateroskleros i hjärtats blodkärl. Således kan den icke-invasiva ultraljudsmetoden fungera som ett hjälpmedel i riskbedömningen av koronarsjukdom. HDL (high-density lipoprotein) eller det sk. goda kolesterolet har en skyddande effekt mot ateroskleros bl.a. genom att förhindra oxidation av LDL (low-density lipoprotein) dvs. det onda kolesterolet. Denna effekt förmedlas i huvudsak av enzymet paraoxonase-1 (PON1) som är bundet till HDL. Vi fann att aktiviteten respektive koncentrationen av PON1 var lägre hos patienter med mera utbredd koronarsjukdom oavsett nivån av HDL kolesterol. Detta fynd tyder på att inte enbart mängden HDL kolesterol i blodet utan även HDL partikelns uppbyggnad har betydelse för uppkomsten och svårighetsgraden av ateroskleros i hjärtats blodkärl. Efter fettrik måltid steg koncentrationen av olika lipoproteiner (bl.a tryglycerider) och dessa korrelerade med oxiderat LDL (oxLDL). Detta fynd ger belägg för att det postprandiella stadiet (= tiden efter fettrik måltid) är förknippat med oxidativ stress. Vi kunde inte påvisa ett samband mellan postprandiella lipoproteiner och ateroskleros, vilket i sin tur skulle tyda på att det postprandiella stadiet och den ökade halten av triglycerider inte har en avgörande betydelse för uppkomsten av ateroskleros. Långtgående slutsatser kan emellertid inte dras, ty detta negativa fynd kan ha berott på många olika faktorer. Däremot kunde vi påvisa ett samband mellan oxLDL och svårighetsgraden av koronarsjukdom. Insulinresistens var förknippat med svårighetsgraden av koronarsjukdom. I all synnerhet kunde vi notera att patienter med insulinresistens hade en mera uttalad ateroskleros i koronarkärlens distala segment. Vårt resultat stöder tanken på att inte enbart diabetes mellitus utan även dess förstadie d.v.s. insulinresistens medför uttalade förändringar i hjärtats blodkärl. Vi kan således konstatera att insulinresistens har en central betydelse hos patienter med koronarsjukdom. ApoE genen kodar för ett kolesteroltransporterande protein kallat apolipoprotein E (apoE). ApoE möjliggör att en del lipoproteiner kan binda till sina receptorer så att kolesterol kan tas upp av cellerna. ApoE finns i olika varianter (ApoE2, ApoE3 och ApoE4). Vi kunde påvisa att patienter med apoE4 hade en mera utbredd ateroskleros både i halsens och i hjärtats blodkärl jämfört med patienter med apoE3. Detta fynd talar för att apoE4 har en betydelse för uppkomsten och svårighetsgraden av ateroskleros

Cardiac steatosis associates with visceral obesity in nondiabetic obese men.

Background: Liver fat and visceral adiposity are involved in the development of the metabolic syndrome (MetS). Ectopic fat accumulation within and around the heart has been related to increased risk of heart disease. The aim of this study was to explore components of cardiac steatosis and their relationship to intra-abdominal ectopic fat deposits and cardiometabolic risk factors in nondiabetic obese men. Methods: Myocardial and hepatic triglyceride (TG) contents were measured with 1.5 T magnetic resonance spectroscopy, and visceral adipose (VAT), abdominal subcutaneous tissue (SAT), epicardial and pericardial fat by magnetic resonance imaging in 37 men with the MetS and in 40 men without the MetS. Results: Myocardial and hepatic TG contents, VAT, SAT, epicardial fat volumes, and pericardial fat volumes were higher in men with the MetS compared with subjects without the MetS (P < .001). All components of cardiac steatosis correlated with SAT, VAT, and hepatic TG content and the correlations seemed to be strongest with VAT. Myocardial TG content, epicardial fat, pericardial fat, VAT, and hepatic TG content correlated with waist circumference, body mass index, high-density lipoprotein cholesterol TGs, very low-density lipoprotein-1 TGs, and the insulin-resistance homeostasis model assessment index. VAT was a predictor of TGs, high-density lipoprotein cholesterol, and measures of glucose metabolism, whereas age and SAT were determinants of blood pressure parameters. Conclusions: We suggest that visceral obesity is the best predictor of epicardial and pericardial fat in abdominally obese subjects. Myocardial TG content may present a separate entity that is influenced by factors beyond visceral adiposity

Cardiac steatosis and left ventricular function in men with metabolic syndrome

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