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Dear Editor, We read the article by Akyüz et al. [1] with great interest. In their study, the authors concluded that the amount of epicardial adipose tissue (EAT) was higher in subjects with xanthelasma than in subjects without. We appreciate their investigation concerning the relationship between xanthelasma and EAT thickness. However, a number of well-known factors may independently affect EAT thickness. These include the metabolic syndrome independent of body mass index, and the correlation between visceral adipose tissue and waist circumference [2, 3] . EAT thickness is significantly higher in patients with nonalcoholic fatty liver disease compared to controls [4] , and patients with subclinical hypothyroidism seem to have a significantly increased EAT thickness [5] . Treatment with statins could induce EAT regression independentPublished online: January 20, 2016

Factors Related to Epicardial Adipose Tissue Thickness