Skip to main content
Log in

Subepicardial adipose tissue thickness and its relation with anthropometric and clinical parameters in pubertal obese children

  • Original Articles
  • Published:
Journal of Endocrinological Investigation Aims and scope Submit manuscript

Abstract

Aim: To determine the relation of echocardiographic subepicardial adipose tissue (SAT) thickness with anthropometric and clinical parameters in pubertal obese children. Subjects and methods: A total of 52 obese pubertal subjects (13.1±1.56 yr, 27 male patients) and 39 age- and gender-matched lean pubertal subjects (13.0±1.28 yr, 16 male patients) were included in the study. Serum glucose, lipid profile, and insulin levels were measured during the fasting state. Each subject underwent a transthoracic echocardiography and the SAT thickness was measured during end-diastole from the parasternal long-axis views. Results: The obese pubertal subjects had significantly higher SAT, triceps skin fold (TSF) thickness (mm), waist (WC) and mid-arm circumference (MAC) values (cm) compared with lean pubertal subjects group (p<0.05). Correlation analysis showed that SAT thickness was significantly related with age, SD score-body mass index (SDS-BMI), BMI, WC, MAC, TSF, and homeostasis model assessment of insulin resistance (HOMA-IR) (p<0.05), whereas there was no significant relation of SAT with hip circumference and waist to hip ratio (p>0.05). As an optimal cut-off point, a SAT thickness of 5.25 mm determined IR with 92% sensitivity and 62.1% specificity. Conclusions: Our study showed that SAT thickness in obese pubertal children shows a good correlation with age, SDS-BMI, BMI, WC, MAC, TSF, and HOMA-IR. In addition, our results suggest that SAT thickness might be used as a supportive data for risk stratification of metabolic syndrome in obese children.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Iacobellis G, Assael F, Ribaudo MC, et al. Epicardial fat from echocardiography: a new method for visceral adipose tissue prediction. Obes Res 2003, 11: 304–10.

    Article  PubMed  Google Scholar 

  2. Rabkin SW. Epicardial fat: properties, function and relationship to obesity. Obes Rev 2007, 8: 253–61.

    Article  PubMed  CAS  Google Scholar 

  3. Iacobellis G, Corradi D, Sharma AM. Epicardial adipose tissue: anatomic, biomolecular and clinical relationships with the heart. Nat Clin Pract Cardiovasc Med 2005, 2: 536–43.

    Article  PubMed  Google Scholar 

  4. Schejbal V. Epicardial fatty tissue of the right ventricle—morphology, morphometry and functional significance. Pneumologie 1989, 43: 490–9.

    PubMed  CAS  Google Scholar 

  5. Eiras S, Teijeira-Fernandez E, Shamagian LG, et al. Extension of coronary artery disease is associated with increased IL-6 and decreased adiponectin gene expression in epicardial adipose tissue. Cytokine 2008, 43: 174–80.

    Article  PubMed  CAS  Google Scholar 

  6. Mazurek T, Zhang L, Zalewski A, et al. Human epicardial adipose tissue is a source of inflammatory mediators. Circulation 2003, 108: 2460–6.

    Article  PubMed  Google Scholar 

  7. Cruz ML, Bergman RN, Goran MI. Unique effect of visceral fat on insulin sensitivity in obese Hispanic children with a family history of type 2 diabetes. Diabetes Care 2002, 25: 1631–6.

    Article  PubMed  Google Scholar 

  8. De Simone M, Verrotti A, Iughetti L, et al. Increased visceral adipose tissue is associated with increased circulating insulin and decreased sex hormone binding globulin levels in massively obese adolescent girls. J Endocrinol Invest 2001, 24: 438–44.

    PubMed  Google Scholar 

  9. Hayashi T, Boyko EJ, McNeely MJ, Leonetti DL, Kahn SE, Fujimoto WY. Visceral adiposity, not abdominal subcutaneous fat area, is associated with an increase in future insulin resistance in Japanese Americans. Diabetes 2008, 57: 1269–75.

    Article  PubMed  CAS  Google Scholar 

  10. Kelley DE, Thaete FL, Troost F, Huwe T, Goodpaster BH. Subdivisions of subcutaneous abdominal adipose tissue and insulin resistance. Am J Physiol Endocrinol Metab 2000, 278: E941–8.

    PubMed  CAS  Google Scholar 

  11. Maffeis C, Manfredi R, Trombetta M, et al. Insulin sensitivity is correlated with subcutaneous but not visceral body fat in overweight and obese prepubertal children. J Clin Endocrinol Metab 2008, 93: 2122–8.

    Article  PubMed  CAS  Google Scholar 

  12. Ross R, Fortier L, Hudson R. Separate associations between visceral and subcutaneous adipose tissue distribution, insulin and glucose levels in obese women. Diabetes Care 1996, 19: 1404–11.

    Article  PubMed  CAS  Google Scholar 

  13. Moran A, Jacobs DR Jr, Steinberger J, et al. Insulin resistance during puberty: results from clamp studies in 357 children. Diabetes 1999, 48: 2039–44.

    Article  PubMed  CAS  Google Scholar 

  14. Potau N, Ibanez L, Rique S, Carrascosa A. Pubertal changes in insulin secretion and peripheral insulin sensitivity. Horm Res 1997, 48: 219–26.

    Article  PubMed  CAS  Google Scholar 

  15. Roemmich JN, Clark PA, Lusk M, et al. Pubertal alterations in growth and body composition. VI. Pubertal insulin resistance: relation to adiposity, body fat distribution and hormone release. Int J Obes Relat Metab Disord 2002, 26: 701–9.

    Article  PubMed  CAS  Google Scholar 

  16. Abaci A, Tascilar ME, Saritas T, et al. Threshold value of subepicardial adipose tissue to detect insulin resistance in obese children. Int J Obes (Lond) 2009, 33: 440–6.

    Article  CAS  Google Scholar 

  17. World Health Organization Multicentre Growth Reference Study Group. Growth reference data for children and adolescents aged 5–19 years. Available at: http://www.who.int/growthref/en/.

  18. American Academy of Pediatrics. National Cholesterol Education Program: Report of the Expert Panel on Blood Cholesterol Levels in Children and Adolescents. Pediatrics 1992, 89: 525–84.

    Google Scholar 

  19. Genuth S, Alberti KG, Bennett P, et al; Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Follow-up report on the diagnosis of diabetes mellitus. Diabetes Care 2003, 26: 3160–7.

    Article  PubMed  Google Scholar 

  20. Valerio G, Licenziati MR, Iannuzzi A, et al. Insulin resistance and impaired glucose tolerance in obese children and adolescents from Southern Italy. Nutr Metab Cardiovasc Dis 2006, 16: 279–84.

    Article  PubMed  CAS  Google Scholar 

  21. Lean ME, Han TS, Deurenberg P. Predicting body composition by densitometry from simple anthropometric measurements. Am J Clin Nutr 1996, 63: 4–14.

    PubMed  CAS  Google Scholar 

  22. Rosner B, Prineas RJ, Loggie JM, Daniels SR. Blood pressure nomograms for children and adolescents, by height, sex, and age, in the United States. J Pediatr 1993, 123: 871–86.

    Article  PubMed  CAS  Google Scholar 

  23. Iacobellis G, Ribaudo MC, Assael F, et al. Echocardiographic epicardial adipose tissue is related to anthropometric and clinical parameters of metabolic syndrome: a new indicator of cardiovascular risk. J Clin Endocrinol Metab 2003, 88: 5163–8.

    Article  PubMed  CAS  Google Scholar 

  24. Iacobellis G, Leonetti F. Epicardial adipose tissue and insulin resistance in obese subjects. J Clin Endocrinol Metab 2005, 90: 6300–2.

    Article  PubMed  CAS  Google Scholar 

  25. Bell LM, Byrne S, Thompson A, et al. Increasing body mass index z-score is continuously associated with complications of overweight in children, even in the healthy weight range. J Clin Endocrinol Metab 2007, 92: 517–22.

    Article  PubMed  CAS  Google Scholar 

  26. Lee S, Bacha F, Gungor N, Arslanian SA. Waist circumference is an independent predictor of insulin resistance in black and white youths. J Pediatr 2006, 148: 188–94.

    Article  PubMed  CAS  Google Scholar 

  27. Sung RY, Yu CC, Choi KC, et al. Waist circumference and body mass index in Chinese children: cutoff values for predicting cardiovascular risk factors. Int J Obes (Lond) 2007, 31: 550–8.

    Article  CAS  Google Scholar 

  28. Okyay K, Balcioglu AS, Tavil Y, Tacoy G, Turkoglu S, Abaci A. A relationship between echocardiographic subepicardial adipose tissue and metabolic syndrome. Int J Cardiovasc Imaging 2008, 24: 577–83.

    Article  PubMed  Google Scholar 

  29. Tansey DK, Aly Z, Sheppard MN. Fat in the right ventricle of the normal heart. Histopathology 2005, 46: 98–104.

    Article  PubMed  CAS  Google Scholar 

  30. Cikim AS, Topal E, Harputluoglu M, et al. Epicardial adipose tissue, hepatic steatosis and obesity. J Endocrinol Invest 2007, 30: 459–64.

    Article  PubMed  CAS  Google Scholar 

  31. Iacobellis G, Barbaro G, Gerstein HC. Relationship of epicardial fat thickness and fasting glucose. Int J Cardiol 2008, 128: 424–6.

    Article  PubMed  Google Scholar 

  32. Siervogel RM, Demerath EW, Schubert C, et al. Puberty and body composition. Horm Res 2003, 60: 36–45.

    Article  PubMed  CAS  Google Scholar 

  33. Travers SH, Jeffers BW, Bloch CA, Hill JO, Eckel RH. Gender and Tanner stage differences in body composition and insulin sensitivity in early pubertal children. J Clin Endocrinol Metab 1995, 80: 172–8.

    PubMed  CAS  Google Scholar 

  34. Bloch CA, Clemons P, Sperling MA. Puberty decreases insulin sensitivity. J Pediatr 1987, 110: 481–7.

    Article  PubMed  CAS  Google Scholar 

  35. Iacobellis G, Willens HJ, Barbaro G, Sharma AM. Threshold Values of high-risk echocardiographic epicardial fat thickness. Obesity (Silver Spring) 2008, 16: 887–92.

    Article  Google Scholar 

  36. Eroglu S, Sade LE, Yildirir A, et al. Epicardial adipose tissue thickness by echocardiography is a marker for the presence and severity of coronary artery disease. Nutr Metab Cardiovasc Dis 2009, 19: 211–7.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to A. Abaci MD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Abaci, A., Ozdemir, O., Hizli, S. et al. Subepicardial adipose tissue thickness and its relation with anthropometric and clinical parameters in pubertal obese children. J Endocrinol Invest 33, 715–719 (2010). https://doi.org/10.1007/BF03346676

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03346676

Key-words

Navigation