Epicardial fat thickness: threshold values and lifestyle correlation in male adolescents

Background: Obese adolescents with high proportion of visceral fat are at higher risk of developing the metabolic syndrome. Objectives: e study aims to investigate if echocardiographic epicardial fat thickness (EF) could be predictive of visceral obesity (VO) early in life and to provide EF threshold values speci c for male adolescents. Further aim was to investigate the association between EF, lifestyle and metabolic disease familiarity. Methods: Anthropometric data were collected from 102 normal weight and overweight, healthy male adolescents (mean age: 14.91 ± 1.98 years); bioelectrical impedance analysis and transthoracic echocardiogram were performed in the same sample. Each participant ful lled a validated self-administered lifestyle questionnaire. Results: We found higher EF values in sedentary adolescents (P < 0.05), in those who never eat fruit and vegetables (P < 0.05), and in those with overweight mothers (P < 0.05). e strongest independent predictor of EF was waist circumference (P < 0.0001). Using the waist to height ratio as a marker of VO, logistic regression analysis revealed that 1 mm EF gain is responsible for seven times higher VO risk (P < 0.0001). Receiver Operat- ing Characteristic (ROC) analysis showed that the optimal cut-o for EF thickness associated to youth VO is 3.2 mm. Conclusion: Ultrasonography EF measurement might be a second-level assessment tool, useful to detect early cardiometabolic damage stage.