Department of Pediatrics, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turquia.
Department of Cardiology, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaraş, Turquia.
Arq Bras Cardiol. 2020 Apr;114(4):675-682. doi: 10.36660/abc.20190197. Epub 2020 Mar 13.
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).
胰岛素抵抗（IR）是肥胖儿童的一种重要疾病，因为它与心血管疾病密切相关。由于分泌的生物活性分子，心外膜脂肪组织（EAT）在 IR 的发展中起作用，这些分子的炎症过程可能导致心房电机械延迟（EMD）。
本研究旨在确定肥胖儿童的 EAT 与 EMD 与 IR 之间的关系。
本研究纳入了 94 例肥胖患者。使用稳态模型评估胰岛素抵抗（HOMA-IR）计算 IR，并将 HOMA-IR 定义为在年龄和性别特异性百分位数曲线上大于第 90 百分位数。根据 IR 将患者分为两组。所有患者均行超声心动图检查。统计学意义设定为双侧 p 值 < 0.05。
IR 组的 EAT 明显更高（p < 0.001）。预测 IR 的 EAT 最佳截断值为 > 3.85mm，具有 92.5%的特异性和 68.5%的敏感性（p = 0.002）。在多变量逻辑回归模型中，EAT（OR = 1.256，95%CI：1.016-1.53，p = 0.035）在调整单变量分析中发现具有统计学意义的变量后，也与 IR 相关。与无 IR 组相比，IR 组的 Inter-和 Intra-心房 EMD 明显延长（p < 0.010；p = 0.032）。
在我们的研究中，我们发现 EAT 与 IR 呈正相关，是 IR 的独立预测因子。（Arq Bras Cardiol. 2020; [在线]。提前印刷，PP.0-0）。
