The relation between epicardial fat thickness and metabolic syndrome

We read the article Usefulness of the epicardial fat tissue thickness as a diagnostic criterion for geriatric patients with metabolic syndrome by Kaya, et al. The authors aimed to evaluate the epicardial fat tissue thickness (EFT) as a diagnostic criterion for geriatric patients with metabolic syndrome (MetS). They concluded that EFT levels were higher in geriatric patients with MetS and can therefore be used as a diagnostic criterion for MetS. Thanks to the authors for their good contribution of the present study, which is successfully designed and well-documented. EFT releases numerous markers which play an important role in MetS. In addition, MetS may be associated with oxidative stress, endothelial dysfunction, and atherosclerosis. Various studies highlighted the importance of EFT in line with inflammatory status in cardiovascular diseases. EFT values are linked to abdominal visceral adiposity and subclinical atherosclerosis, which seems to have high capacity of proinflammatory activity. Furthermore, EFT is also associated with nonalcoholic fatty liver disease, chronic kidney disease, hyperlipidemia, type 2 diabetes, hypertension, smoking, and carotid atherosclerosis. Moreover, thyroid dysfunction, whether overt or subclinical, has multiple effects on the cardiovascular system. EFT may be a useful marker of subclinic atherosclerosis in patients with subclinic hypothyroidism or overt hypothyroidism. After that, many methods can be used for EFT measurements. Although epicardial fat has three segments, the echocardiography cannot accurately measure the EFT levels because echocardiography measure two segments linearly. In fact, computed tomography (CT) or magnetic resonance imaging (MRI) are the gold standard method in assessing