{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,13]],"date-time":"2026-09-13T01:37:10Z","timestamp":1789263430528,"version":"build-2803163510"},"reference-count":53,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2024,8,13]],"date-time":"2024-08-13T00:00:00Z","timestamp":1723507200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Health and Family Planning Commission of Sichuan Province","award":["ZH2023-103"],"award-info":[{"award-number":["ZH2023-103"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: As a novel biomarker for cardiovascular diseases, epicardial adipose tissue (EAT) has been linked to psoriasis. We conducted an updated systematic review, building upon a previous report on the relationship between EAT and psoriasis. Methods: We searched Medline, Embase, and the Cochrane Central Register of Controlled Trials. The methodological quality of each study was assessed using the Newcastle\u2013Ottawa Scale. The pooled mean difference (MD) or standardized mean difference (SMD) and the corresponding confidence interval (CIs) were calculated. Results: We included 10 studies with 1287 participants. Five of the included studies were of high methodological quality, while the other five were of moderate quality. The pooled data indicated that psoriasis patients had significantly increased EAT compared to individuals in the control group (SMD 1.53, 95% CI 0.61 to 2.45, 9 studies, 1195 participants). The subgroup analysis showed that psoriasis patients had significantly increased EAT thickness compared with the controls (SMD 2.45, 95% CI 0.73 to 4.17, 5 studies, 657 participants). Similarly, EAT area in single-slice CT images was significantly higher in the psoriasis group than in the control group (SMD 0.45, 95% CI 0.14 to 0.76, 2 studies, 195 participants). The EAT volume based on CT images appeared to be higher in the psoriasis group than in the control group, but the difference was not statistically significant (SMD 0.32, 95% CI \u22120.06 to 0.70, 2 studies, 343 participants). Conclusions: EAT, especially echocardiographic EAT thickness and CT-determined EAT area, was significantly associated with psoriasis, but CT-determined EAT volume was not.<\/jats:p>","DOI":"10.3390\/jcm13164761","type":"journal-article","created":{"date-parts":[[2024,8,13]],"date-time":"2024-08-13T10:54:54Z","timestamp":1723546494000},"page":"4761","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Epicardial Adipose Tissue and Psoriasis: A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9790-4513","authenticated-orcid":false,"given":"Xiaomei","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Dermatology, West China Hospital, Sichuan University, Chengdu 610041, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongmei","family":"Xiang","sequence":"additional","affiliation":[{"name":"Department of Dermatology, West China Hospital, Sichuan University, Chengdu 610041, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Lu","sequence":"additional","affiliation":[{"name":"Medical Insurance Office, West China Hospital, Sichuan University, Chengdu 610041, China"},{"name":"Chinese Cochrane Center, West China Hospital, Sichuan University, Chengdu 610041, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1875-1692","authenticated-orcid":false,"given":"Ming","family":"Yang","sequence":"additional","affiliation":[{"name":"Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu 610041, China"},{"name":"National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu 610041, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,8,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1016\/S0140-6736(14)61909-7","article-title":"Psoriasis","volume":"386","author":"Boehncke","year":"2015","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"806","DOI":"10.1001\/jamadermatol.2022.1756","article-title":"Patient-Relevant Outcomes in Psoriasis: A Systematic Review","volume":"158","author":"Hilhorst","year":"2022","journal-title":"JAMA Dermatol."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Armstrong, A.W., Foster, S.A., Comer, B.S., Lin, C.-Y., Malatestinic, W., Burge, R., and Goldblum, O. (2018). Real-world health outcomes in adults with moderate-to-severe psoriasis in the United States: A population study using electronic health records to examine patient-perceived treatment effectiveness, medication use, and healthcare resource utilization. BMC Dermatol., 18.","DOI":"10.1186\/s12895-018-0072-2"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1001\/jamadermatol.2021.4723","article-title":"Psoriasis and Cardiovascular Disease\u2014An Ounce of Prevention Is Worth a Pound of Cure","volume":"158","author":"Garshick","year":"2022","journal-title":"JAMA Dermatol."},{"key":"ref_5","first-page":"e27767","article-title":"Psoriasis a Cause of Cardiovascular Diseases: A Review Article","volume":"14","author":"Gupta","year":"2022","journal-title":"Cureus"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e413","DOI":"10.1002\/mco2.413","article-title":"Epicardial adipose tissue, metabolic disorders, and cardiovascular diseases: Recent advances classified by research methodologies","volume":"4","author":"Song","year":"2023","journal-title":"MedComm"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1038\/nrendo.2015.58","article-title":"Local and systemic effects of the multifaceted epicardial adipose tissue depot","volume":"11","author":"Iacobellis","year":"2015","journal-title":"Nat. Rev. Endocrinol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1016\/j.ijcard.2018.09.089","article-title":"Epicardial adipose tissue and cardiovascular diseases","volume":"278","author":"Ansaldo","year":"2019","journal-title":"Int. J. Cardiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e009238","DOI":"10.1161\/CIRCHEARTFAILURE.121.009238","article-title":"Epicardial Adipose Tissue and Outcome in Heart Failure with Mid-Range and Preserved Ejection Fraction","volume":"15","author":"Manintveld","year":"2022","journal-title":"Circ. Heart Fail."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1186\/s12933-019-0917-y","article-title":"Epicardial adipose tissue predicts incident cardiovascular disease and mortality in patients with type 2 diabetes","volume":"18","author":"Christensen","year":"2019","journal-title":"Cardiovasc. Diabetol."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Konwerski, M., G\u0105secka, A., Opolski, G., Grabowski, M., and Mazurek, T. (2022). Role of Epicardial Adipose Tissue in Cardiovascular Diseases: A Review. Biology, 11.","DOI":"10.3390\/biology11030355"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1081","DOI":"10.1111\/bjd.12569","article-title":"Increased epicardial fat tissue is a marker of subclinical atherosclerosis in patients with psoriasis","volume":"169","author":"Atci","year":"2013","journal-title":"Br. J. Dermatol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1159\/000354726","article-title":"Epicardial fat thickness is independently associated with psoriasis","volume":"228","author":"Akyildiz","year":"2014","journal-title":"Dermatology"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"47","DOI":"10.5543\/tkda.2014.78949","article-title":"Epicardial fat thickness in patients with psoriasis vulgaris","volume":"42","author":"Bacaksiz","year":"2014","journal-title":"Turk. Kardiyol. Dern. Ars."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1111\/ced.12216","article-title":"Patients with psoriasis have an increased amount of epicardial fat tissue","volume":"39","author":"Balci","year":"2014","journal-title":"Clin. Exp. Dermatol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1111\/jdv.12516","article-title":"Epicardial adipose tissue and coronary artery calcification in psoriasis patients","volume":"29","author":"Torres","year":"2015","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1186\/s12944-016-0271-y","article-title":"Epicardial fat tissue in patients with psoriasis:a systematic review and meta-analysis","volume":"15","author":"Wang","year":"2016","journal-title":"Lipids Health Dis."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"276","DOI":"10.5603\/CJ.a2017.0031","article-title":"Chemerin as a marker of subclinical cardiac involvement in psoriatic patients","volume":"24","author":"Aksu","year":"2017","journal-title":"Cardiol. J."},{"key":"ref_19","first-page":"14","article-title":"Evaluation of arterial stiffness in patients with psoriasis vulgaris","volume":"55","author":"Colgecen","year":"2021","journal-title":"Turkderm Turk. Arch. Dermatol. Venereol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"357","DOI":"10.25259\/IJDVL_214_19","article-title":"Carotid intima-media thickness and epicardial fat thickness predict precoronary artery disease status in psoriasis","volume":"87","author":"Girisha","year":"2021","journal-title":"Indian. J. Dermatol. Venereol. Leprol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1349","DOI":"10.1111\/1346-8138.14618","article-title":"Evaluation of epicardial adipose tissue volume and coronary artery calcification in Japanese patients with psoriasis vulgaris","volume":"45","author":"Momose","year":"2018","journal-title":"J. Dermatol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"b2535","DOI":"10.1136\/bmj.b2535","article-title":"Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement","volume":"339","author":"Moher","year":"2009","journal-title":"BMJ"},{"key":"ref_23","unstructured":"Higgins, J., Thomas, J., Chandle, r.J., Cumpston, M., Li, T., Page, M., and Welch, V. (2021). Cochrane Handbook for Systematic Reviews of Interventions Version 6.2 (Updated February 2021), John Wiley & Sons."},{"key":"ref_24","unstructured":"Wells, G.A., Wells, G., Shea, B., Shea, B., O\u2019Connell, D., Peterson, J., Welch, V., Losos, M., Tugwell, P., and Ga, S.W. (2024, March 23). The Newcastle-Ottawa Scale (NOS) for Assessing the Quality of Nonrandomised Studies in Meta-Analyses. Available online: http:\/\/www.ohri.ca\/programs\/clinical_epidemiology\/oxford.htm."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1136\/bmj.327.7414.557","article-title":"Measuring inconsistency in meta-analyses","volume":"327","author":"Higgins","year":"2003","journal-title":"BMJ"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1016\/j.jaad.2021.09.069","article-title":"Epicardial adipose tissue volume is greater in men with severe psoriasis, implying an increased cardiovascular disease risk: A cross-sectional study","volume":"86","author":"Ellis","year":"2022","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Anyfanti, P., Margouta, A., Goulas, K., Gavriilaki, M., Lazaridou, E., Patsatsi, A., and Gkaliagkousi, E. (2022). Endothelial Dysfunction in Psoriasis: An Updated Review. Front. Med., 9.","DOI":"10.3389\/fmed.2022.864185"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1016\/j.jaad.2011.06.035","article-title":"Underdiagnosis and undertreatment of cardiovascular risk factors in patients with moderate to severe psoriasis","volume":"67","author":"Kimball","year":"2012","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"e000062","DOI":"10.1161\/JAHA.113.000062","article-title":"Psoriasis and major adverse cardiovascular events: A systematic review and meta-analysis of observational studies","volume":"2","author":"Armstrong","year":"2013","journal-title":"J. Am. Heart Assoc."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"889","DOI":"10.1007\/s10741-017-9644-1","article-title":"Epicardial adipose tissue as a metabolic transducer: Role in heart failure and coronary artery disease","volume":"22","author":"Patel","year":"2017","journal-title":"Heart Fail. Rev."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"4914","DOI":"10.2174\/1381612825666191206091105","article-title":"Epicardial Fat: A New Therapeutic Target in Psoriasis","volume":"25","author":"Kamath","year":"2019","journal-title":"Curr. Pharm. Des."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1051","DOI":"10.1002\/cphy.c160034","article-title":"Role of Epicardial Adipose Tissue in Health and Disease: A Matter of Fat?","volume":"7","author":"Gaborit","year":"2017","journal-title":"Compr. Physiol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"907","DOI":"10.1016\/j.ahj.2007.03.019","article-title":"Human epicardial adipose tissue: A review","volume":"153","author":"Sacks","year":"2007","journal-title":"Am. Heart J."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1038\/oby.2003.45","article-title":"Epicardial Fat from Echocardiography: A New Method for Visceral Adipose Tissue Prediction","volume":"11","author":"Iacobellis","year":"2003","journal-title":"Obes. Res."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Hu, S.C., and Lan, C.E. (2017). Psoriasis and Cardiovascular Comorbidities: Focusing on Severe Vascular Events, Cardiovascular Risk Factors and Implications for Treatment. Int. J. Mol. Sci., 18.","DOI":"10.3390\/ijms18102211"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1111\/bjd.13271","article-title":"Influence of interleukin-6 gene polymorphisms in epicardial adipose tissue and coronary artery calcification in patients with psoriasis","volume":"172","author":"Torres","year":"2015","journal-title":"Br. J. Dermatol."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Zimmermann, G.S., Ruether, T., von Ziegler, F., Greif, M., Tittus, J., Schenzle, J., Becker, C., and Becker, A. (2021). Increased Pericardial Adipose Tissue in Smokers. J. Clin. Med., 10.","DOI":"10.3390\/jcm10153382"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"65","DOI":"10.2147\/PTT.S85189","article-title":"Psoriasis and smoking: Links and risks","volume":"6","author":"Naldi","year":"2016","journal-title":"Psoriasis"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"303","DOI":"10.2147\/DMSO.S145862","article-title":"Effect of aerobic exercise on echocardiographic epicardial adipose tissue thickness in overweight individuals","volume":"11","author":"Bairapareddy","year":"2018","journal-title":"Diabetes Metab. Syndr. Obes."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1007\/s00403-024-03124-8","article-title":"Tumor necrosis factor-alpha presence in post mortem cardiac tissue of psoriatic patients","volume":"316","author":"Romanelli","year":"2024","journal-title":"Arch. Dermatol. Res."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1038\/s41569-022-00679-9","article-title":"Epicardial adipose tissue in contemporary cardiology","volume":"19","author":"Iacobellis","year":"2022","journal-title":"Nat. Rev. Cardiol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1730","DOI":"10.1016\/j.jacc.2021.08.037","article-title":"Modulation of Cardiac Arrhythmogenesis by Epicardial Adipose Tissue: JACC State-of-the-Art Review","volume":"78","author":"Ernault","year":"2021","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1016\/j.coph.2016.01.004","article-title":"Epicardial fat: A new cardiovascular therapeutic target","volume":"27","author":"Iacobellis","year":"2016","journal-title":"Curr. Opin. Pharmacol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"416","DOI":"10.5152\/akd.2015.5991","article-title":"How do we measure epicardial adipose tissue thickness by transthoracic echocardiography?","volume":"15","year":"2015","journal-title":"Anatol. J. Cardiol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1007\/s11604-010-0524-z","article-title":"Single-slice epicardial fat area measurement: Do we need to measure the total epicardial fat volume?","volume":"29","author":"Oyama","year":"2011","journal-title":"Jpn. J. Radiol."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Yin, L., Yan, C., Yang, C., Dong, H., Xu, S., Li, C., and Zeng, M. (2022). Measurement of epicardial adipose tissue using non-contrast routine chest-CT: A consideration of threshold adjustment for fatty attenuation. BMC Med. Imaging, 22.","DOI":"10.1186\/s12880-022-00840-3"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"20190770","DOI":"10.1259\/bjr.20190770","article-title":"Novel imaging biomarkers: Epicardial adipose tissue evaluation","volume":"93","author":"Monti","year":"2020","journal-title":"Br. J. Radiol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1186\/s41747-022-00274-0","article-title":"Quantification of epicardial adipose tissue in obese patients using an open-bore MR scanner","volume":"6","author":"Secchi","year":"2022","journal-title":"Eur. Radiol. Exp."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"966","DOI":"10.1002\/jcsm.12948","article-title":"Chest computed tomography-derived muscle mass and quality indicators, in-hospital outcomes, and costs in older inpatients","volume":"13","author":"Shen","year":"2022","journal-title":"J. Cachexia Sarcopenia Muscle"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1186\/s41824-021-00107-0","article-title":"Development of artificial intelligence in epicardial and pericoronary adipose tissue imaging: A systematic review","volume":"5","author":"Zhang","year":"2021","journal-title":"Eur. J. Hybrid. Imaging"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"e190045","DOI":"10.1148\/ryai.2019190045","article-title":"Fully Automated CT Quantification of Epicardial Adipose Tissue by Deep Learning: A Multicenter Study","volume":"1","author":"Commandeur","year":"2019","journal-title":"Radiol. Artif. Intell."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1007\/s10654-010-9491-z","article-title":"Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses","volume":"25","author":"Stang","year":"2010","journal-title":"Eur. J. Epidemiol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"80","DOI":"10.13105\/wjma.v5.i4.80","article-title":"Assessing the quality of studies in meta-analyses: Advantages and limitations of the Newcastle Ottawa Scale","volume":"5","author":"Luchini","year":"2017","journal-title":"World J. Meta-Anal."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/16\/4761\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:35:59Z","timestamp":1760110559000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/16\/4761"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,13]]},"references-count":53,"journal-issue":{"issue":"16","published-online":{"date-parts":[[2024,8]]}},"alternative-id":["jcm13164761"],"URL":"https:\/\/doi.org\/10.3390\/jcm13164761","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8,13]]}}}