{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T08:58:19Z","timestamp":1781254699284,"version":"3.54.1"},"reference-count":29,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T00:00:00Z","timestamp":1780876800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Sarcopenia is a major geriatric condition associated with functional decline and adverse outcomes. Cardiac fat depots exhibit metabolic activity and are linked to cardiometabolic risk; however, the extent to which epicardial adipose tissue (EAT) and pericoronary adipose tissue (PCAT) quantified on standard thoracic computed tomography (CT) scans are associated with sarcopenia in older inpatients remains inadequately explored. This study investigated the associations of EAT and PCAT thickness with sarcopenia. Materials and Methods: This is a retrospective observational study using CT data obtained for clinical purposes and routine geriatric assessment data. In this single-center retrospective study, 101 inpatients aged \u226565 years who underwent unenhanced thoracic CT and bioelectrical impedance analysis within 3 months were included. EAT and PCAT thicknesses were measured using standardized methods. Sarcopenia status was based on a previously established clinical diagnosis according to EWGSOP2 criteria. Multivariable logistic regression, body mass index (BMI)-stratified analyses, and ROC curve evaluations were performed. Results: The participants had a mean age of 78.5 \u00b1 7.6 years; 54.5% were female. Fifty-five patients (54.5%) met the diagnostic criteria for sarcopenia. PCAT was significantly thicker in sarcopenic participants relative to non-sarcopenic ones (12.25 \u00b1 2.50 vs. 11.17 \u00b1 2.32 mm, p = 0.028), while no corresponding difference was observed for EAT (p = 0.959). After controlling for age, sex, and BMI, each 1 mm increase in PCAT thickness was independently associated with an increased odds of sarcopenia (OR 1.399, 95% CI 1.133\u20131.727, p = 0.002). With the addition of the PCAT, the discriminatory power was modest (AUC 0.637 overall and 0.715 for BMI \u226525 kg\/m2). In exploratory stratified analyses, the association was numerically larger in the BMI \u226525 kg\/m2 subgroup (OR 1.48, p = 0.008); however, the formal BMI-by-PCAT interaction was not statistically significant (p = 0.290), so this subgroup finding is considered hypothesis-generating. Conclusions: PCAT thickness measured on routine non-contrast thoracic CT was associated with prevalent sarcopenia, whereas EAT thickness was not. ROC analyses showed modest discrimination; therefore, any proposed cut-offs should be considered exploratory and require prospective validation and external confirmation before clinical use.<\/jats:p>","DOI":"10.3390\/medicina62061115","type":"journal-article","created":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T16:25:16Z","timestamp":1780935916000},"page":"1115","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pericoronary, but Not Epicardial, Cardiac Fat Thickness Is Associated with Sarcopenia in Hospitalized Older Adults"],"prefix":"10.3390","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9193-5327","authenticated-orcid":false,"given":"K\u00fcbra","family":"Erdo\u011fan","sequence":"first","affiliation":[{"name":"Division of Geriatrics, Department of Internal Medicine, Ankara Bilkent City Hospital, 06200 Ankara, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1939-4738","authenticated-orcid":false,"given":"R\u0131dvan","family":"Erten","sequence":"additional","affiliation":[{"name":"Division of Geriatrics, Department of Internal Medicine, Ankara Bilkent City Hospital, 06200 Ankara, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rana","family":"Tuna Do\u011frul","sequence":"additional","affiliation":[{"name":"Division of Geriatrics, Department of Internal Medicine, Ankara Bilkent City Hospital, 06200 Ankara, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Velihan","family":"\u00c7ayhan","sequence":"additional","affiliation":[{"name":"Department of Radiology, Ankara Bilkent City Hospital, 06200 Ankara, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serap","family":"Boz","sequence":"additional","affiliation":[{"name":"Division of Geriatrics, Department of Internal Medicine, Ankara Bilkent City Hospital, 06200 Ankara, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0044-7681","authenticated-orcid":false,"given":"\u0130mran","family":"Ceren","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, 06200 Ankara, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ertu\u011frul","family":"Demirel","sequence":"additional","affiliation":[{"name":"Division of Geriatrics, Department of Internal Medicine, Ankara Bilkent City Hospital, 06200 Ankara, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hande","family":"Selvi \u00d6ztorun","sequence":"additional","affiliation":[{"name":"Division of Geriatrics, Department of Internal Medicine, Faculty of Medicine, Ankara Y\u0131ld\u0131r\u0131m Beyaz\u0131t University, 06010 Ankara, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4766-3982","authenticated-orcid":false,"given":"G\u00fcne\u015f","family":"Eken","sequence":"additional","affiliation":[{"name":"Division of Geriatrics, Department of Internal Medicine, Faculty of Medicine, Health Science University, 06200 Ankara, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0384-4957","authenticated-orcid":false,"given":"Kamile","family":"S\u0131lay","sequence":"additional","affiliation":[{"name":"Division of Geriatrics, Department of Internal Medicine, Faculty of Medicine, Ankara Y\u0131ld\u0131r\u0131m Beyaz\u0131t University, 06010 Ankara, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1093\/ageing\/afy169","article-title":"Sarcopenia: Revised European consensus on definition and diagnosis","volume":"48","author":"Bahat","year":"2019","journal-title":"Age Ageing"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1093\/ageing\/afs194","article-title":"Sarcopenia and mortality risk in frail older persons aged 80 years and older: Results from the ILSIRENTE study","volume":"42","author":"Landi","year":"2013","journal-title":"Age Ageing"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Wan, S.N., Thiam, C.N., Ang, Q.X., Engkasan, J., and Ong, T. (2023). Incident sarcopenia in hospitalized older people: A systematic review. PLoS ONE, 18.","DOI":"10.1371\/journal.pone.0289379"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"127","DOI":"10.5543\/tkda.2021.65635","article-title":"Epicardial adipose tissue volume predicts long-term major adverse cardiovascular events in patients with type 2 diabetes","volume":"49","author":"Uygur","year":"2021","journal-title":"Turk Kardiyol. Dern. Ars."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"742","DOI":"10.2174\/0113816128284695240219093612","article-title":"Cholesteryl Ester Transfer Protein (CETP) Variations in Relation to Lipid Profiles and Cardiovascular Diseases: An Update","volume":"30","author":"Dabravolski","year":"2024","journal-title":"Curr. Pharm. Des."},{"key":"ref_6","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_7","doi-asserted-by":"crossref","first-page":"112447","DOI":"10.1016\/j.exger.2024.112447","article-title":"The relationship between muscle strength and epicardial fat in healthy adults","volume":"192","author":"Komici","year":"2024","journal-title":"Exp. Gerontol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1534","DOI":"10.1161\/CIRCULATIONAHA.123.064071","article-title":"Sarcopenia and cardiovascular diseases","volume":"147","author":"Damluji","year":"2023","journal-title":"Circulation"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e240473","DOI":"10.1148\/radiol.240473","article-title":"Association of epicardial adipose tissue changes on serial chest CT scans with mortality: Insights from the National Lung Screening Trial","volume":"314","author":"Langenbach","year":"2025","journal-title":"Radiology"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/j.jcmg.2018.06.025","article-title":"Epicardial adipose tissue and myocardial fibrosis in aortic stenosis: Relationship with symptoms and outcomes: A study using cardiac magnetic resonance imaging","volume":"12","author":"Davin","year":"2019","journal-title":"JACC Cardiovasc. Imaging"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1148\/rg.2021200056","article-title":"Opportunistic screening at abdominal CT: Use of automated body composition biomarkers for added cardiometabolic value","volume":"41","author":"Pickhardt","year":"2021","journal-title":"Radiographics"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"914","DOI":"10.1001\/jama.1963.03060120024016","article-title":"Studies of illness in the aged. The index of ADL: A standardized measure of biological and psychosocial function","volume":"185","author":"Katz","year":"1963","journal-title":"JAMA"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1093\/geront\/9.3_Part_1.179","article-title":"Assessment of older people: Self-maintaining and instrumental activities of daily living","volume":"9","author":"Lawton","year":"1969","journal-title":"Gerontologist"},{"key":"ref_14","first-page":"709","article-title":"Geriatric Depression Scale","volume":"24","author":"Yesavage","year":"1988","journal-title":"Psychopharmacol. Bull."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"M366","DOI":"10.1093\/gerona\/56.6.M366","article-title":"Screening for undernutrition in geriatric practice: Developing the short-form mini-nutritional assessment (MNA-SF)","volume":"56","author":"Rubenstein","year":"2001","journal-title":"J. Gerontol. A Biol. Sci. Med. Sci."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1016\/0022-3956(75)90026-6","article-title":"\u201cMini-Mental State\u201d. A practical method for grading the cognitive state of patients for the clinician","volume":"12","author":"Folstein","year":"1975","journal-title":"J. Psychiatr. Res."},{"key":"ref_17","first-page":"416","article-title":"Epicardial adipose tissue: Far more than a fat depot","volume":"4","author":"Talman","year":"2014","journal-title":"Cardiovasc. Diagn. Ther."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"388","DOI":"10.6061\/clinics\/2014(06)04","article-title":"Epicardial adipose tissue and pericoronary fat thickness measured with 64-multidetector computed tomography: Potential predictors of the severity of coronary artery disease","volume":"69","author":"Demircelik","year":"2014","journal-title":"Clinics"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1152\/jappl.2000.89.2.465","article-title":"Estimation of skeletal muscle mass by bioelectrical impedance analysis","volume":"89","author":"Janssen","year":"2000","journal-title":"J. Appl. Physiol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1557","DOI":"10.1016\/j.clnu.2016.02.002","article-title":"Cut-off points to identify sarcopenia according to European Working Group on Sarcopenia in Older People definition","volume":"35","author":"Bahat","year":"2016","journal-title":"Clin. Nutr."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1148\/radiology.143.1.7063747","article-title":"The meaning and use of the area under a receiver operating characteristic (ROC) curve","volume":"143","author":"Hanley","year":"1982","journal-title":"Radiology"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"eaal2658","DOI":"10.1126\/scitranslmed.aal2658","article-title":"Detecting human coronary inflammation by imaging perivascular fat","volume":"9","author":"Antonopoulos","year":"2017","journal-title":"Sci. Transl. Med."},{"key":"ref_23","first-page":"73","article-title":"Sarcopenic obesity and cardiovascular disease risk and mortality: A systematic review and meta-analysis","volume":"30","author":"Zhang","year":"2025","journal-title":"Anatol. J. Cardiol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"2111","DOI":"10.1007\/s15010-025-02555-3","article-title":"Impact of sarcopenia and obesity on mortality in older adults with SARS-CoV-2 infection: Automated deep learning body composition analysis in the NAPKON-SUEP cohort","volume":"53","author":"Schluessel","year":"2025","journal-title":"Infection"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1016\/j.numecd.2007.10.002","article-title":"Sarcopenic obesity: A new category of obesity in the elderly","volume":"18","author":"Zamboni","year":"2008","journal-title":"Nutr. Metab. Cardiovasc. Dis."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1186\/2042-6410-3-13","article-title":"Sex differences in human adipose tissues\u2014The biology of pear shape","volume":"3","author":"Karastergiou","year":"2012","journal-title":"Biol. Sex. Differ."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1744","DOI":"10.3390\/tomography10110128","article-title":"Correlation of sarcopenia with coronary artery disease severity and pericoronary adipose tissue attenuation: A coronary CT study","volume":"10","author":"Albano","year":"2024","journal-title":"Tomography"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1097\/RTI.0000000000000583","article-title":"Imaging of the pericoronary adipose tissue (PCAT) using cardiac computed tomography: Modern clinical implications","volume":"36","author":"Goeller","year":"2021","journal-title":"J. Thorac. Imaging"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"2460","DOI":"10.1161\/01.CIR.0000099542.57313.C5","article-title":"Human epicardial adipose tissue is a source of inflammatory mediators","volume":"108","author":"Mazurek","year":"2003","journal-title":"Circulation"}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/6\/1115\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T08:33:40Z","timestamp":1781253220000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/6\/1115"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,8]]},"references-count":29,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["medicina62061115"],"URL":"https:\/\/doi.org\/10.3390\/medicina62061115","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,8]]}}}