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Importance of epicardial adipose tissue thickness measurement in obese adolescents, its relationship with carotid intima-media thickness, and echocardiographic findings.

AIM
The aim of the present study was to analyze the relationship between epicardial adipose tissue thickness (EATT) and echocardiographic parameters, such as carotid intima-media thickness (cIMT), myocardial performance index (MPI), left ventricular (LV) systolic and diastolic function, and LV mass index in adolescents with obesity.


PATIENTS AND METHODS
One hundred and thirty eight obese adolescents and 63 lean subjects were enrolled in the study. The body mass index standard deviation scores (BMI-SDS) between 1.65-2.49 and 2.50-2.99 were considered as mild-moderate and severe obesity, respectively. All of the subjects underwent transthoracic echocardiographic examination for determination of LV function, LV structure, LV mass index, and MPI. Epicardial adipose tissue thickness and cIMT were also measured during echocardiography.


RESULTS
The EATT measurements were increased significantly in patients with severe obesity compared to lean subjects (7.38±1.76 vs 4.28±0.79 mm, respectively; p = 0.001), but there was no significant difference between the obesity groups. The average LV mass index measurements were higher in both mild-moderately and severely obese patients in comparison with the lean children (87.5±34.8, 88.5±23.0, and 62.4±18.2 g/m2, respectively; p < 0.01), but there was no significant difference between the obesity groups. EATT was positively correlated with BMI-SDS, waist and hip circumference, blood pressure, fasting glucose, insulin, HOMA-IR, hs-CRP (high-sensitivity C-reactive protein), triglyceride levels, cIMT, LV mass index, and MPI in the severe obesity group. EATT was the only independent predictor of cIMT in the multivariate analysis (standardized β coefficient = 0.70, p < 0.001).


CONCLUSIONS
The present study demonstrates a close relationship between EATT and cIMT, and LV functions and LV mass index in obese adolescents. Assessments of EATT and cIMT in particular during routine echocardiographic examinations might be used as a feasible and reliable method for the evaluation of obesity and its related cardiovascular risks during childhood.