Comparison of reducing epicardial fat by exercise, diet or bariatric surgery weight loss strategies: A systematic review and meta-analysis
Abstract
The objectives were to determine whether epicardial fat (EAT) is subject to modification, and whether various strategies accomplish this end point and the relationship between weight loss and EAT. A systematic review of the literature following meta-analysis guidelines was conducted using the search strategy 'epicardial fat' OR 'epicardial adipose tissue' AND 'diet' OR 'exercise' OR 'bariatric surgery (BS)' OR 'change in body weight' limited to humans. Eleven articles were identified with 12 intervention approaches of which eight studies showed a statistically significant reduction in EAT. A random-effects meta-analysis suggests an overall significant reduction of 1.12 standardized units (95% CI = [-1.71, -0.54], P value < 0.01). While there is a large amount of heterogeneity across study groups, a substantial amount of this variability can be accounted for by considering intervention type and change in body mass index (BMI). These variables were incorporated into a random-effects meta-regression model. Using this analysis, significant EAT reduction occurred with diet and BS but not with exercise. BMI reductions correlated significantly with EAT reductions for diet-based interventions, i.e. for some but not all interventions. In conclusion, EAT, a factor that is significantly associated with coronary artery disease, can be modified. The type of intervention, in addition to the amount of weight loss achieved, is predictive of the amount of EAT reduction.
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The relationship between change in BMI and change in EAT is significant for diet, less apparent for bariatric surgery, and virtually absent for exercise.
“A study comparing these three weight loss strategies reports that the relationship between change in BMI and change in EAT is significant for diet, less apparent for bariatric surgery, and virtually absent for exercise [146].”
From Dysregulated epicardial adipose tissue as a risk factor and potential therapeutic target of heart failure with preserved ejection fraction in diabetes (2022) · cites this paper as [146]
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- Authors
- Rabkin, S. W., & Campbell, H.
- Affiliations
- University of British Columbia (CA)
- EMMES Canada Burnaby BC Canada
- Corresponding author
- Rabkin, S. W.
- ORCID
- Rabkin, S. W.
- Venue
- Obesity Reviews
- Publisher
- Wiley
- Published
- 2015-03-05
- Volume
- 16
- Issue
- 5
- Pages
- 406-415
- ISSN
- 1467-7881 (ISSN-L)
- 1467-789X
- OpenAlex
- W1518443297
- Cited by
- 114
- References
- 38
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 8 · 2023: 16 · 2022: 15 · 2021: 10 · 2020: 12 · 2019: 18 · 2018: 8 · 2017: 14 · 2016: 7 · 2015: 2
- FWCI
- 1.78
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Obesity Reviews (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Disease and Adiposity
- Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
- Health Sciences › Medicine › Physiology › Adipose Tissue and Metabolism
- Keywords
- epicardial adipose tissue, visceral fat reduction, weight loss interventions, diet, physical activity, bariatric surgery, body mass index, coronary artery disease
- MeSH terms
- Adipose Tissue, Diet, Reducing, Humans, Obesity, Pericardium, Risk Factors, Weight Loss, Exercise, Treatment Outcome, Bariatric Surgery
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