Targeting epicardial adipose tissue with exercise, diet, bariatric surgery or pharmaceutical interventions: A systematic review and meta-analysis
Abstract
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.
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Pharmacologic agents produce more specific and clinically meaningful shrinkage of epicardial fat adiposity than non-pharmacologic weight loss measures.
“A recent systematic review with a meta-analysis of randomized and nonrandomized trials, reports that the shrinkage of epicardial fat adiposity reached with pharmacologic agents is more specific and clinically meaningful than with the above reported measures.”
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 [147]
Both lipid and glucose-lowering agents independently reduce EAT mass, although with significant heterogeneity between studies.
“Particularly, both lipid and glucose-lowering agents independently reduce EAT mass, although with a significant heterogeneity between studies [147].”
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 [147]
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- Authors
- Launbo, N., Zobel, E. H., von Scholten, B. J., Færch, K., Jørgensen, P. G., & Christensen, R. H.
- Affiliations
- Rigshospitalet (DK)
- Steno Diabetes Center Copenhagen (DK)
- Steno Diabetes Center Copenhagen Gentofte Denmark
- University of Copenhagen (DK)
- Herlev Hospital (DK)
- Corresponding author
- Launbo, Natja
- Venue
- Obesity Reviews
- Publisher
- Wiley
- Published
- 2020-09-08
- Volume
- 22
- Issue
- 1
- Pages
- e13136-e13136
- ISSN
- 1467-7881 (ISSN-L)
- 1467-789X
- OpenAlex
- W3083872392
- Cited by
- 76
- References
- 70
- Citations by year
- 2026: 7 · 2025: 17 · 2024: 10 · 2023: 15 · 2022: 15 · 2021: 12
- FWCI
- 1.79
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Obesity Reviews (publishedVersion)
- PubMed (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
- Funders
- Steno Diabetes Center Copenhagen (SDCC 3.A Complications)
- Novo Nordisk Fonden (NNF17OC0027822)
- 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, pericardial adipose tissue, cardiac adipose tissue, weight loss interventions, exercise training, dietary intervention, bariatric surgery, pharmacological interventions, obesity, cardiovascular risk
- MeSH terms
- Adipose Tissue, Cardiovascular Diseases, Diet, Humans, Pericardium, Weight Loss, Exercise, Anti-Obesity Agents, Bariatric Surgery
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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