Relationship of Epicardial Adipose Tissue Thickness with Early Indicators of Atherosclerosis and Cardiac Functional Changes in Obese Adolescents with Metabolic Syndrome

Overview

Journal J Clin Res Pediatr Endocrinol

Specialties Endocrinology
Pediatrics

Date 2013 Sep 28

PMID 24072083

Citations 15

Authors

Bedir Akyol

Mehmet Boyraz

Cevriye Aysoy

Affiliations

Soon will be listed here.

Abstract

Objective: Epicardial adipose tissue thickness (EATT) is suggested as a new cardiometabolic risk factor. Carotid intima-media thickness (IMT) is a potential indicator of subclinical atherosclerosis in patients with metabolic syndrome (MS). We investigated the association of EATT with carotid IMT and cardiac functional changes in obese adolescents with MS.

Methods: One hundred thirty-eight obese adolescents and 63 lean subjects were enrolled in the study. The obese subjects were divided into two subgroups based on the presence or absence of MS (MS group and non-MS group). All subjects underwent transthoracic echocardiographic examination for determination of left ventricular (LV) function, LV mass index (LVMI), and myocardial performance index (MPI). EATT and carotid IMT were also measured during echocardiography.

Results: The average LVMI measurements were higher in both MS and non-MS obese patients in comparison with the lean children. The MS group had significantly higher LVMI measurements than the non-MS and lean groups (88.5±23.0, 67.5±24.8 g/m2, and 62.4±18.2 g/m2, respectively; p<0.01). Carotid IMT was higher in both the MS and non-MS obese patients in comparison with the lean group. The MS group had significantly higher carotid IMT measurements than the non-MS and lean groups (0.91±0.23, 0.78±0.18, and 0.52±0.08 mm, respectively; p<0.01). The EATT was also increased significantly in patients with MS compared to lean adolescents (7.42±1.55 vs. 4.28±0.79mm; p=0.001). EATT was positively correlated with body mass index-SDS, waist circumference, fasting glucose, insulin, homeostasis model assessment-insulin resistance, triglyceride levels, LV thickness, LVMI, and MPI in the MS obese group. EATT was the only independent predictor of carotid IMT in the multivariate analysis (β= 0.69, p<0.001).

Conclusion: The findings of the present study demonstrate a close relationship of EATT with carotid IMT and early cardiac dysfunction in obese adolescents with MS. Assessment of EATT and carotid IMT in routine echocardiographic examinations is suggested as a feasible and reliable method for the evaluation of obesity with MS and its related cardiovascular risks in children and adolescents.

Citing Articles

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References

Iacobellis G, Pistilli D, Gucciardo M, Leonetti F, Miraldi F, Brancaccio G . Adiponectin expression in human epicardial adipose tissue in vivo is lower in patients with coronary artery disease. Cytokine. 2005; 29(6):251-5. DOI: 10.1016/j.cyto.2004.11.002. View

. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics. 2004; 114(2 Suppl 4th Report):555-76. View

Hatipoglu N, Ozturk A, Mazicioglu M, Kurtoglu S, Seyhan S, Lokoglu F . Waist circumference percentiles for 7- to 17-year-old Turkish children and adolescents. Eur J Pediatr. 2007; 167(4):383-9. DOI: 10.1007/s00431-007-0502-3. View

Iacobellis G, Barbaro G . The double role of epicardial adipose tissue as pro- and anti-inflammatory organ. Horm Metab Res. 2008; 40(7):442-5. DOI: 10.1055/s-2008-1062724. View

Cole T, Bellizzi M, Flegal K, Dietz W . Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ. 2000; 320(7244):1240-3. PMC: 27365. DOI: 10.1136/bmj.320.7244.1240. View

Wong C, OMoore-Sullivan T, Leano R, Byrne N, Beller E, Marwick T . Alterations of left ventricular myocardial characteristics associated with obesity. Circulation. 2004; 110(19):3081-7. DOI: 10.1161/01.CIR.0000147184.13872.0F. View

Eroglu S, Sade L, Yildirir A, Bal U, Ozbicer S, Ozgul A . Epicardial adipose tissue thickness by echocardiography is a marker for the presence and severity of coronary artery disease. Nutr Metab Cardiovasc Dis. 2008; 19(3):211-7. DOI: 10.1016/j.numecd.2008.05.002. View

Gastaldelli A, Basta G . Ectopic fat and cardiovascular disease: what is the link?. Nutr Metab Cardiovasc Dis. 2010; 20(7):481-90. DOI: 10.1016/j.numecd.2010.05.005. View

Aydin H, Toprak A, Deyneli O, Yazici D, Tarcin O, Sancak S . Epicardial fat tissue thickness correlates with endothelial dysfunction and other cardiovascular risk factors in patients with metabolic syndrome. Metab Syndr Relat Disord. 2010; 8(3):229-34. DOI: 10.1089/met.2009.0080. View

10.

Tounian P, Aggoun Y, Dubern B, Varille V, Guy-Grand B, Sidi D . Presence of increased stiffness of the common carotid artery and endothelial dysfunction in severely obese children: a prospective study. Lancet. 2001; 358(9291):1400-4. DOI: 10.1016/S0140-6736(01)06525-4. View

11.

De Simone G, Devereux R, Wallerson D . Echocardiographic assessment of left ventricular hypertrophy in rats using a simplified approach. Am J Hypertens. 1994; 7(6):555-8. DOI: 10.1093/ajh/7.6.555. View

12.

Keskin M, Kurtoglu S, Kendirci M, Atabek M, Yazici C . Homeostasis model assessment is more reliable than the fasting glucose/insulin ratio and quantitative insulin sensitivity check index for assessing insulin resistance among obese children and adolescents. Pediatrics. 2005; 115(4):e500-3. DOI: 10.1542/peds.2004-1921. View

13.

Liu K, Chan Y, Chan W, Chan J, Chu C . Mesenteric fat thickness is an independent determinant of metabolic syndrome and identifies subjects with increased carotid intima-media thickness. Diabetes Care. 2006; 29(2):379-84. DOI: 10.2337/diacare.29.02.06.dc05-1578. View

14.

Tei C, Ling L, Hodge D, Bailey K, Oh J, Rodeheffer R . New index of combined systolic and diastolic myocardial performance: a simple and reproducible measure of cardiac function--a study in normals and dilated cardiomyopathy. J Cardiol. 1995; 26(6):357-66. View

15.

Iacobellis G, Pond C, Sharma A . Different "weight" of cardiac and general adiposity in predicting left ventricle morphology. Obesity (Silver Spring). 2006; 14(10):1679-84. DOI: 10.1038/oby.2006.192. View

16.

Iacobellis G, Leonetti F . Epicardial adipose tissue and insulin resistance in obese subjects. J Clin Endocrinol Metab. 2005; 90(11):6300-2. DOI: 10.1210/jc.2005-1087. View

17.

Savva S, Tornaritis M, Savva M, Kourides Y, Panagi A, Silikiotou N . Waist circumference and waist-to-height ratio are better predictors of cardiovascular disease risk factors in children than body mass index. Int J Obes Relat Metab Disord. 2000; 24(11):1453-8. DOI: 10.1038/sj.ijo.0801401. View

18.

Lanes R, Soros A, Flores K, Gunczler P, Carrillo E, Bandel J . Endothelial function, carotid artery intima-media thickness, epicardial adipose tissue, and left ventricular mass and function in growth hormone-deficient adolescents: apparent effects of growth hormone treatment on these parameters. J Clin Endocrinol Metab. 2005; 90(7):3978-82. DOI: 10.1210/jc.2005-0091. View

19.

Nelson M, Mookadam F, Thota V, Emani U, Al Harthi M, Lester S . Epicardial fat: an additional measurement for subclinical atherosclerosis and cardiovascular risk stratification?. J Am Soc Echocardiogr. 2010; 24(3):339-45. DOI: 10.1016/j.echo.2010.11.008. View

20.

Natale F, Tedesco M, Mocerino R, De Simone V, Di Marco G, Aronne L . Visceral adiposity and arterial stiffness: echocardiographic epicardial fat thickness reflects, better than waist circumference, carotid arterial stiffness in a large population of hypertensives. Eur J Echocardiogr. 2009; 10(4):549-55. DOI: 10.1093/ejechocard/jep002. View