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The Relationship Between Epicardial Adipose Tissue and Insulin Resistance in Obese Children
Hatice Güneş1, Hakan Güneş2, Fatih Temiz3
1Department of Pediatrics, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turquia.
Insights
Epicardial adipose tissue (EAT) is linked to insulin resistance (IR) in obese children. Higher EAT levels predict IR and are associated with atrial electromechanical delay (EMD), indicating potential cardiovascular risks.
Area of Science:
- Cardiology
- Pediatrics
- Metabolic Disorders
Background:
- Insulin resistance (IR) is a significant concern in obese children, closely linked to cardiovascular diseases.
- Epicardial adipose tissue (EAT) contributes to IR through bioactive molecules, potentially causing atrial electromechanical delay (EMD).
Purpose of the Study:
- To investigate the association between EAT and EMD in obese children with IR.
- To determine if EAT is an independent predictor of IR in this population.
Main Methods:
- Ninety-four obese children were assessed for IR using HOMA-IR.
- Echocardiography was performed to measure EAT and evaluate inter- and intra-atrial EMD.
- Patients were stratified into IR and non-IR groups based on the 90th percentile.
Main Results:
- Obese children with IR exhibited significantly higher EAT levels (p < 0.001).
- EAT > 3.85 mm was identified as a predictor of IR (92.5% specificity, 68.5% sensitivity; p = 0.002).
- EAT remained an independent predictor of IR in multivariate analysis (OR = 1.256, p = 0.035).
- Prolonged inter- and intra-atrial EMD was observed in the IR group (p < 0.010; p = 0.032).
Conclusions:
- Epicardial adipose tissue (EAT) is positively correlated with insulin resistance (IR) in obese children.
- EAT serves as an independent predictor of IR in this pediatric cohort.
- The findings suggest a link between EAT, IR, and atrial electromechanical delay, highlighting potential cardiovascular implications.
Abstract:
Background Insulin resistance (IR) is an important disorder in obese children because it is closely related to cardiovascular diseases. Epicardial adipose tissue (EAT) plays a role in the development of IR due to secreted bioactive molecules, and the inflammatory process of these molecules may cause atrial electromechanical delay (EMD). Objective The objective of our study was to determine the relationship between EAT and EMD with IR in obese children. Methods Ninety-four obese patients were included in the study. IR was calculated using the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) and defined as HOMA-IR greater than the 90thpercentile in an age- and sex-specific percentile curve. Patients were divided into two groups according to their IR. All patients underwent echocardiographic examinations. Statistical significance was set to a two-sided p-value < 0.05. Results EAT was significantly higher in the IR group (p < 0.001). The optimal cut-off value for EAT to predict IR was found to be > 3.85 mm, with 92.5% specificity and 68.5% sensitivity (p = 0.002). In the multivariate logistic regression model, EAT (OR = 1.256, 95% CI: 1.016-1.53, p = 0.035) was also associated with IR after adjustment for variables found to be statistically significant in univariate analysis. Inter- and intra-atrial EMD was significantly prolonged in the IR group compared to the group without IR (p < 0.010; p = 0.032 respectively). Conclusion: In our study, we revealed that EAT was positively correlated with IR and was an independent predictor of IR. (Arq Bras Cardiol. 2020; [online].ahead print, PP.0-0).
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