Journal of Pediatric Endocrinology and Metabolism, 2025 (SCI-Expanded, Scopus)
Objectives: This study aimed to evaluate the relationship between epicardial adipose tissue (EAT) thickness and hepatic steatosis in pediatric patients with obesity, exploring EAT as a potential biomarker for cardiovascular risk. Methods: A retrospective analysis was conducted on children with obesity aged 10–18, including 48 patients with NAFLD and 50 age- and sex-matched controls with no liver steatosis. EAT thickness was measured using echocardiography, and liver fat was assessed via ultrasound. Correlations between EAT, metabolic parameters, and anthropometric measurements were examined. Results: EAT thickness was significantly more excellent in the NAFLD group than in controls (p<0.001), with an optimal cutoff of 1.6 mm predicting hepatic steatosis with 98 % sensitivity and specificity. Positive correlations were found between EAT thickness, body mass index (BMI) Z-scores, and liver steatosis stages. Additionally, structural cardiac changes, such as increased RVDD and IVSd, were observed in the NAFLD group, suggesting early signs of cardiac remodeling. Conclusions: EAT thickness may be a non-invasive biomarker for identifying cardiovascular risk in pediatric patients with obesity and NAFLD. Early detection of elevated EAT could guide interventions to reduce obesity-related cardiovascular risk in this population.