| Abstract [eng] |
Summary: Background. There is increasing evidence that the distribution of adipose tissue such as subcutaneous, visceral or cardiac fat depots and not only total body fat play a critical role in cardiovascular risk. Despite the differences in the risk of ischemic heart disease between the different social and demographic groups, a possible association between sociodemographic factors and the distribution of fat depots remains underexplored in context of ischemic heart disease. The aim of this study was to review scientific literature about the association of the distribution of adipose tissue with various social and demographic factors among patients with ischemic heart disease. Objectives of this study included the analysis of 1. Subcutaneous adipose tissue among social and demographic groups of patients with ischemic heart disease; 2. Abdominal visceral adipose tissue among social and demographic groups of patients with ischemic heart disease; 3. Cardiac adipose tissue (epicardial, pericardial, paracardial, perivascular) among social and demographic groups of patients with ischemic heart disease. Material and methods. A narrative literature review was conducted via structured searches with keywords and MeSH-terms in PubMed and Google Scholar. The selection criteria included studies focusing on adipose tissue distribution in relation to sex, ethnicity, and socioeconomic indicators, particularly in cardiovascular contexts. Results. Studies have shown, that men often exhibit greater visceral adiposity, women often have more subcutaneous fat until menopause, showing a possible hormonal influence. Asian individuals often demonstrate higher visceral and epicardial fat at lower body mass index values, African Americans often have lower visceral adiposity but similar metabolic risk. Lower occupational status is often associated with larger depots of visceral fat, while lower education, older age and belonging to a non-White ethnic group often predicts a higher ratio of visceral to subcutaneous adipose tissue. Cardiac fat increased with age and was higher in men. Epicardial fat was more common in South and East Asians and Whites, and associated with alcohol use, hypertension, and diabetes. Epicardial adipose tissue emerged as a clinically valuable and potentially modifiable marker of early cardiovascular risk. Conclusions. Demographic and social factors are associated with differences in the accumulation of adipose tissue. These findings suggest the need for inclusion of social factors and imaging-based fat depot measurement into cardiovascular screening in vulnerable populations to improve early detection of high-risk individuals. |
