TY - JOUR

T1 - Targeting epicardial adipose tissue with exercise, diet, bariatric surgery or pharmaceutical interventions

T2 - A systematic review and meta-analysis

AU - Launbo, Natja

AU - Zobel, Emilie H.

AU - von Scholten, Bernt Johan

AU - Faerch, Kristine

AU - Jorgensen, Peter G.

AU - Christensen, Regitse H.

PY - 2021

Y1 - 2021

N2 - Epicardial adipose tissue (EAT) and pericardial adipose tissue (PAT) are metabolically active fat depots implicated in cardiovascular disease, and EAT has potential as a novel cardiac risk factor, suitable as a target for interventions. The objective of this systematic review and meta-analysis was to investigate the evidence whether EAT and PAT volume can be reduced by weight-loss interventions (exercise, diet, bariatric surgery or pharmaceutical interventions). A systematic literature search identified 34 studies that were included in the qualitative synthesis (exercise,n= 10, diet,n= 5, bariatric surgery,n= 9 and pharmaceutical interventions,n= 10). Of the 34 studies, 10 reported sufficient data to be included in the meta-analysis. The meta-analysis was only conducted for changes in EAT volume, since only few controlled studies reported changes in PAT (n= 3) or total cardiac adipose tissue volume (n= 1). A significant pooled effect size (ES) for reduction in EAT volume was observed following weight-loss interventions as compared with control interventions (ES = -0.89, 95% CI: -1.23 to -0.55,P<0.001). When comparing the effect of exercise training versus control on EAT volume reduction, there was a significant pooled ES favouring exercise training (ES: -1.11, 95% CI: -1.57 to -0.65,P<0.001). Similarly, the ES of pharmaceutical versus control interventions on EAT volume reduction was significant, favouring pharmaceutical interventions (ES: -0.79, 95% CI: -1.37 to -0.21,P<0.0072). In conclusion, this systematic review and meta-analysis provides evidence that exercise, diet, bariatric surgery and pharmaceutical interventions can reduce cardiac adipose tissue volume.

AB - Epicardial adipose tissue (EAT) and pericardial adipose tissue (PAT) are metabolically active fat depots implicated in cardiovascular disease, and EAT has potential as a novel cardiac risk factor, suitable as a target for interventions. The objective of this systematic review and meta-analysis was to investigate the evidence whether EAT and PAT volume can be reduced by weight-loss interventions (exercise, diet, bariatric surgery or pharmaceutical interventions). A systematic literature search identified 34 studies that were included in the qualitative synthesis (exercise,n= 10, diet,n= 5, bariatric surgery,n= 9 and pharmaceutical interventions,n= 10). Of the 34 studies, 10 reported sufficient data to be included in the meta-analysis. The meta-analysis was only conducted for changes in EAT volume, since only few controlled studies reported changes in PAT (n= 3) or total cardiac adipose tissue volume (n= 1). A significant pooled effect size (ES) for reduction in EAT volume was observed following weight-loss interventions as compared with control interventions (ES = -0.89, 95% CI: -1.23 to -0.55,P<0.001). When comparing the effect of exercise training versus control on EAT volume reduction, there was a significant pooled ES favouring exercise training (ES: -1.11, 95% CI: -1.57 to -0.65,P<0.001). Similarly, the ES of pharmaceutical versus control interventions on EAT volume reduction was significant, favouring pharmaceutical interventions (ES: -0.79, 95% CI: -1.37 to -0.21,P<0.0072). In conclusion, this systematic review and meta-analysis provides evidence that exercise, diet, bariatric surgery and pharmaceutical interventions can reduce cardiac adipose tissue volume.

KW - epicardial adipose tissue

KW - pericardial adipose tissue

KW - weight-loss interventions

KW - TYPE-2 DIABETIC-PATIENTS

KW - PERICARDIAL FAT

KW - WEIGHT-LOSS

KW - AEROBIC EXERCISE

KW - POSTMENOPAUSAL WOMEN

KW - CLINICAL-TRIAL

KW - ABDOMINAL FAT

KW - VISCERAL FAT

KW - CARDIAC FAT

KW - LIVER FAT

U2 - 10.1111/obr.13136

DO - 10.1111/obr.13136

M3 - Review

C2 - 32896056

VL - 22

JO - Obesity Reviews

JF - Obesity Reviews

SN - 1467-7881

IS - 1

M1 - e13136

ER -