Evaluation of the thickness of epicardial adipose tissue and inflammation in smokers

Cigarettes contain various toxic, radioactive and carcinogenic substances that are harmful to health. Smoking is the leading cause of preventable deaths. Epicardial adipose tissue is a real visceral fat tissue found around the heart. Epicardial adipose tissue has metabolic, thermogenic and mechanical effects. Epicardial adipose tissue produces numerous bioactive cytokines. Epicardial adipose tissue can show various local or systemic effects with these cytokines. The goal in inflammation, which can be defined as a reaction of the body against any stimulus that is perceived as harmful, is to detect the damaged tissue and subsequently to destroy it. Many parameters are used to show the presence and extent of inflammation. There are many pathologies related to smoking and epicardial adipose tissue. Both smoking and epicardial adipose tissue are associated with inflammation and atherosclerosis. Based on this, it is thought that there is a relationship between smoking and epicardial adipose tissue. The objective of this study was to evaluate smokers and non-smoker healthy individuals and in order to determine the relationship between the thickness of epicardial adipose tissue and inflammation. This study included a total of 259 healthy female and male individuals aged between 18-65 years who presented to the Internal Disease outpatient clinics of Erzincan Binali Yildirim University Medical Faculty Mengucek Gazi Training & Research Hospital for general control, without known diabetes mellitus, chronic liver disease, chronic renal failure, thyroid disease, hypertension, left ventricular dysfunction, and a history of revascularization due to coronary artery disease, without investigation outcomes that can suggest these diseases, those without active infection and who were in normal range of body mass index. The thickness of epicardial adipose tissue was measured with transthoracic echocardiography in the participants and thickness of epicardial adipose tissue was compared within the smokers and non-smokers. In addition, the effects of smoking and the thickness of epicardial adipose tissue on various parameters were also evaluated. There was a statistically significant difference between the groups consisting of smokers and non-smokers in terms of the thickness of epicardial adipose tissue. In our study, there was a moderate positive correlation between age, body mass index, smoking as years and pack-year values and the thickness of epicardial adipose tissue. Whereas weak correlations at various rates were found between the daily number of cigarettes smoked, diastolic blood pressure, fasting blood glucose, ALT, AST, total cholesterol, triglycerides, LDL-cholesterol, CRP, uric acid, MPV, platelet counts, platelet to lymphocyte ratio values and the thickness of epicardial adipose tissue. It was found that smoking was the most important determinant of the thickness of epicardial adipose tissue. The other determinants of the thickness of epicardial adipose tissue were found as age, body mass index, CRP and gender. In addition, in our study statistically significant differences were found between the smokers and non-smokers in terms of HDL-cholesterol, triglycerides, uric acid, monocyte counts, Monocyte/HDL ratio, CRP, white blood cell (WBC) counts, platelet-to-lymphocyte ratio, platelet counts, neutrophil counts and ALT values. The significant correlation found between smoking and the thickness of epicardial adipose tissue suggests that increased thickness of epicardial adipose tissue can be used as a marker of inflammatory and atherosclerotic risks. Keywords: Smoke, Epicardial Adipose Tissue, Inflammation, Atherosclerosis