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Threshold value of subepicardial adipose tissue to detect insulin resistance in obese children
A Abaci1, M E Tascilar, T Saritas
1Department of Pediatric Endocrinology, Gulhane Military Medical Academy, Ankara, Turkey. ayhanabaci@gmail.com
Insights
Subepicardial adipose tissue (SAT) in obese children correlates with age, BMI, and intima-media thickness (IMT). A 4.1 mm SAT cutoff shows potential for screening insulin resistance.
Area of Science:
- Pediatric Endocrinology
- Cardiovascular Health
- Obesity Research
Background:
- Subepicardial adipose tissue (SAT) is an active endocrine organ.
- The relationship between SAT, insulin resistance, and intima-media thickness (IMT) in obese children remains under-explored.
- Obesity in children is linked to increased cardiovascular risk factors.
Purpose of the Study:
- To investigate the association between echocardiographically measured SAT and insulin resistance in obese children.
- To evaluate the relationship between SAT and IMT in this pediatric population.
Main Methods:
- Study included 46 obese children and 30 age/gender-matched lean controls.
- Obesity defined by BMI > 97th percentile.
- Echocardiography used to measure SAT thickness; fasting blood tests for glucose, insulin, lipids, and triglycerides.
Main Results:
- Obese children exhibited significantly higher SAT thickness and IMT compared to lean controls (P=0.001).
- SAT showed significant correlations with age (r=0.589, P=0.001), BMI (r=0.625, P=0.02), and IMT (r=0.343, P=0.02).
- No significant correlation was found between SAT and insulin resistance (r=0.170, P=0.253).
Conclusions:
- While SAT is not directly correlated with insulin resistance in obese children, it is linked to age, BMI, and IMT.
- A SAT thickness cutoff of 4.1 mm demonstrated high sensitivity (90%) in predicting insulin resistance.
- Echocardiographic SAT measurement may serve as a valuable, non-invasive screening tool for identifying obese children at risk for insulin resistance.
Aim:
Until now, the association between subepicardial adipose tissue (SAT), insulin resistance and intima-media thickness (IMT) has not been evaluated in obese children. In this study, we evaluated whether echocardiographic SAT is related to insulin resistance and IMT in obese children.
Subjects And Methods:
A total of 46 obese subjects (10.2+/-2.5 years of age, 25 male patients) and 30 age- and gender-matched lean subjects (10.8+/-3.1 years of age, 13 male patients) were included in this study. The criterion for diagnosing obesity was defined as the body mass index (BMI) being over 97% percentile of the same gender and age. Serum triglyceride (TG), low- and high-density lipoprotein, cholesterol, glucose and insulin levels were measured during the fasting state. Each subject underwent a transthoracic echocardiogram and the SAT thickness was measured during end-diastole from the parasternal long-axis views.
Results:
The obese subjects had significantly higher SAT thickness and IMT values compared with the subjects in the control group (5.7+/-1.4 vs 3.0+/-0.7 mm, 0.78+/-0.15 vs 0.51+/-0.11 mm, P=0.001, respectively). Simple linear regression analysis showed no significant correlation between SAT and insulin resistance (r=0.170, P=0.253), whereas there was significant correlation between SAT and BMI, age and IMT (r=0.625, P=0.02, r=0.589, P=0.001, r=0.343, P=0.02, respectively). As an optimal cutoff point, a SAT thickness of 4.1 mm determined insulin resistance with 90% sensitivity and 61% specificity.
Conclusions:
Our study showed that SAT was significantly correlated with age, BMI and IMT, but not insulin resistance. However, our findings suggest that a 4.1 mm cutoff of SAT thickness might be used as a simple, inexpensive and non-invasive screening method because of its ability to predict insulin resistance with high sensitivity in obese children.