Introduction and objective: Atherosclerosis is one of the most important causes of obesity-related diseases. The clinical symptoms usually begin in adulthood, but the pathological changes in vascular structure could be observed in a much earlier period. Carotid intimamedia thickness (cIMK) which is one of the noninvasive marker of early atherosclerotic changes, has been shown to be significantly increased in obese children. Subepicardial adipose tissue (SAT) is a component of visceral adipose tissue. Obesity is the most common predisposing factor leading to the increase of SAT. Transthoracic echocardiography is a valuable imaging modality to evaluate SAT. The determination of SATT could be important in grading the risk of obesity-related complications. We aimed to evaluate the relationship between SATT and cIMK with anthropometric and metabolic parameters in obese children with his study.
Materials and methods: This study was conducted at Child Health and Disease Clinic of Turgut Ozal University Faculty of Medicine between January 2014 and September 2014. The childrens age were between 7 and 17 years. 29 obese girls and 27 obese boys were included in the study a total of 56 pubertal children. 27 girls and 29 boys were included in the study a total of 56 pubertal children as control group. Pubertal examination was performed according to Tanner stages. Tanner stage II was considered as pubertal. SATT was measured on the right ventricle by transthoracic echocardiography and cIMK by high-resolution B-mode Doppler ultrasonography (USG) in all children in the obese and control group. Serum fasting blood glucose, fasting insulin, HOMA-IR, LDL and HDL cholesterol, total cholesterol, and triglycerides were measured biochemically. Height, body weight, BMI, and waist circumference were measured as anthropometric parameters. All parameters were compared between groups and within groups in this study, and evaluated for statistical significance.
Results: The mean age was 12.9±2.4 years in obese group and 12.9±2.2 years in the control group. There were no statistically significant differences between obese group and control group in terms of average age, average height, mean fasting blood glucose, and mean right cIMK (P>0.05). There were statistically significant differences in the average weight, BMI, waist circumference, fasting blood level, HOMA-IR, total cholesterol level, LDL cholesterol level, TG level, SATT, and left cIMK between the obese and control group (P<0.05). All these paramaters were higher in the obese group than the control group. HDL cholesterol level was statistically lower in the obese group than the control group. There was a strong positive relationship between weight, BMI, waist circumference, fasting insulin, HOMA-IR and SATT; and a moderate positive relationship between LDL cholesterol and SATT. There was a moderate negative relationship between HDL cholesterol and SATT. There was a moderate positive relationship between weight, waist circumference and right cIMK. There was a moderate positive relationship between weight and left cIMK.
Discussion: The lipid profile is impaired in childhood obesity with increasing BMI. Insulin resistance is observed, and SATT and cIMK values are increased. SATT and cIMK show a significant relationship with some of the anthropometric and metabolic parameters. These results indicate that SATT and cIMK could show the cardiovascular risk factors associated with childhood obesity. Childhood SATT and cIMK predict the problems that may arise secondary to obesity in adulthood.
01 - 03 Oct 2015
European Society for Paediatric Endocrinology