Ann Pediatr Endocrinol Metab.  2019 Dec;24(4):220-225. 10.6065/apem.2019.24.4.220.

Perirenal and epicardial fat and their association with carotid intima-media thickness in children

• López-Bermejo A
• Prats-Puig A
• Osiniri I
• Martínez-Calcerrada JM
• Bassols J

• KMID: 2468722
• DOI: http://doi.org/10.6065/apem.2019.24.4.220

Abstract

Recent data suggest that subclinical atherosclerosis is more related to visceral adipose tissue distribution than to overall fat mass. Both perirenal fat and epicardial fat are visceral fat depots surrounding the kidneys and the myocardium, respectively, which can be easily assessed by ultrasound. Their clinical relevance in children is largely unknown. This review describes studies relating perirenal and epicardial fat to cardiovascular disease or carotid intima-media thickness (cIMT), a well-established surrogate for subclinical atherosclerosis, and discusses this in context with our own data from children. In adults, both perirenal and epicardial fat are useful biological markers of visceral obesity. The former has been related to hypertension in overweight subjects and with atherosclerosis in patients with human immunodeficiency virus. The latter was associated with several metabolic syndrome components and with calcification of the carotid artery. In healthy prepubertal children, both epicardial and perirenal fat thickness, rather than total body fat mass, were related to cIMT. Ultrasonography measures of perirenal and epicardial fat are related to atherosclerosis in adults and may be convenient tools for the assessment of cardiometabolic risk in children.

Keyword

Body fat distribution; Intra-abdominal fat; Cardiovascular diseases; Carotid intima-media thickness; Child

MeSH Terms

Adipose Tissue
Adult
Atherosclerosis
Biomarkers
Body Fat Distribution
Cardiovascular Diseases
Carotid Arteries
Carotid Intima-Media Thickness*
Child*
HIV
Humans
Hypertension
Intra-Abdominal Fat
Kidney
Myocardium
Obesity, Abdominal
Overweight
Ultrasonography
Biomarkers

Figure

• 

  Fig. 1. (A) Echocardiographic carotid intima-media thickness. Diastolic images were obtained using a linear 12-MHz transducer at the level of the distal common carotid artery, 1 cm away from its bifurcation. The intima-media thickness in the image is indicated between the 2 cursors and marked using the number 1. (B) Echocardiographic perirenal fat thickness. Children were placed in the supine position and the probe was moved to find the position at which the surface of the kidney was almost parallel to the skin. Longitudinal scans were then performed using a linear 12-MHz transducer. The thickness from the inner side of the abdominal musculature to the surface of the kidney was measured. The perirenal fat thickness in the image is indicated between the 2 cursors and marked using the number 3. (C) Echocardiographic epicardial fat thickness. Children were placed in the left lateral decubitus position. Measurements of the fat thickness adjacent to the free wall of the right ventricle were taken from the parasternal long-axis views using a linear 12-MHz transducer. Epicardial adipose tissue appears as an echo-free space between the pericardium and myocardium indicated by the 2 cursors and marked using the number 1.

• 

  Fig. 2. Scatter plot of perirenal fat and the cIMT of children according to BMI categories. White dots and a dotted line depict lean children (BMI-SDS<1), gray dots and a dashed line depict overweight (OW) children (≤1 BMI-SDS <2), and black dots and a solid line depict obese children (BMI-SDS ≥2). cIMT, carotid intima-media thickness; BMI, body mass index; SDS, standard deviation score.

Reference

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