Comparison of reducing epicardial fat by exercise, diet or bariatric surgery XXXX strategies: a systematic review and meta-analysis.

@entity1 @entity453 @entity353 @entity1386
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 @entity353 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 @entity1 . 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 @entity1386 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 @entity453 , can be modified. The type of intervention, in addition to the amount of @entity353 achieved, is predictive of the amount of @entity1386 .
