Schusterova I, Leenen F H H, Jurko A, Sabol F, Takacova J
Childrens Faculty Hospital, Kosice, Slovakia.
Pediatr Obes. 2014 Feb;9(1):63-70. doi: 10.1111/j.2047-6310.2012.00134.x. Epub 2013 Mar 18.
What is already known about this subject The prevalence of childhood obesity has increased markedly in the past 2 decades. Abdominal fat is a better predictor of risk than body mass index. Waist circumference (WC) as a measure of abdominal fat has limited sensitivity and specificity. What this study adds Epicardial adipose tissue (EAT) as measured by echocardiography represents a simple and reliable marker of visceral adiposity. In children, both body mass index and EAT show a similar or better correlation with markers of cardiometabolic risk than does waist circumference.
Epicardial adipose tissue (EAT) is the visceral fat deposit around the heart and is commonly increased in obese subjects. EAT is related to cardiometabolic risk factors and non-alcoholic fatty liver disease (NAFLD) in adults, but this relationship is not well known in children.
Echocardiographic assessment of EAT and its association with cardiometabolic risk factors in overweight and obese children.
In 25 (mean age 13.0 ± 2.3) overweight and obese subjects and 24 lean controls, blood pressure (BP), WC, fasting plasma glucose and insulin, lipids, uric acid and hepatic enzymes were measured. EAT thickness was measured by transthoracic echocardiography.
In overweight and obese subjects, EAT was significantly higher compared to normal weight children. Overweight and obese children had significantly higher body mass index (BMI), WC, BP, triglycerides (TAG), low-density lipoprotein and total cholesterol, hepatic enzymes alanine aminotransferase (ALT) and γ-glutamyl transferase, and lower high-density lipoprotein cholesterol (HDL-C). EAT correlated significantly with BP, TAG, uric acid, HDL-C, apoprotein B and ALT. Correlation coefficients were similar or better than for WC, but similar or lower than for BMI.
EAT thickness in children is associated with an unfavourable cardiometabolic risk profile including biochemical signs of NAFLD and hyperuricaemia, but is not a stronger indicator than BMI.
关于该主题已知的信息：在过去20年中，儿童肥胖的患病率显著增加。腹部脂肪比体重指数更能预测风险。腰围（WC）作为腹部脂肪的一种测量方法，其敏感性和特异性有限。本研究的补充内容：通过超声心动图测量的 epicardial 脂肪组织（EAT）是内脏肥胖的一种简单可靠的标志物。在儿童中，体重指数和EAT与心脏代谢风险标志物的相关性与腰围相似或更好。
Epicardial 脂肪组织（EAT）是心脏周围的内脏脂肪沉积物，在肥胖受试者中通常会增加。EAT与成人的心脏代谢危险因素和非酒精性脂肪性肝病（NAFLD）有关，但这种关系在儿童中并不为人所知。
对超重和肥胖儿童进行EAT的超声心动图评估及其与心脏代谢危险因素的关联。
对25名（平均年龄13.0±2.3）超重和肥胖受试者以及24名瘦对照组进行血压（BP）、WC、空腹血糖和胰岛素、血脂、尿酸和肝酶的测量。通过经胸超声心动图测量EAT厚度。
与正常体重儿童相比，超重和肥胖受试者的EAT显著更高。超重和肥胖儿童的体重指数（BMI）、WC、BP、甘油三酯（TAG）、低密度脂蛋白和总胆固醇、肝酶丙氨酸转氨酶（ALT）和γ-谷氨酰转移酶显著更高，而高密度脂蛋白胆固醇（HDL-C）更低。EAT与BP、TAG、尿酸、HDL-C、载脂蛋白B和ALT显著相关。相关系数与WC相似或更好，但与BMI相似或更低。
儿童的EAT厚度与包括NAFLD生化指标和高尿酸血症在内的不良心脏代谢风险特征相关，但不是比BMI更强的指标。
