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

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.

Early Appearance of Epicardial Adipose Tissue through Human Development

“…Our results also show that in fetuses of 32 weeks of gestation, lobules exhibit a depot-specific architecture with marked fibrous septa, and a morphology similar to that described previously for visceral fat [ 35 ]. In this line, EAT behaves similarly to other adipose tissues such as subcutaneous and visceral AT, in which the progenitor cell subset repartition is different.…”

Cardiometabolic and Cardiovascular Complications of Obesity in Children

“…The cIMT of a subgroup of these adolescents also showed a positive association with soluble intercellular adhesion molecule 1 [163]. Other authors have observed that in prepuberal children EAT and PAT are better predictors of cIMT than BMI [164]. Similarly, another study found that HOMA-IR and QUICKI, markers of insulin resistance, are independent predictors of cIMT in boys with overweight and obesity, but not in girls.…”

Sex-Specific Differences in Related Indicators of Blood Pressure in School-Age Children With Overweight and Obesity: A Cross-Sectional Study

“…Visceral adipose tissue was considered to be a kind of “ectopic fat” because this fat reservoir was not the usual location of fat storage, compared with subcutaneous adipose tissue. In particular, abdominal visceral adipose tissue was more likely to increase the risk of CVD ( 20 , 21 ). A pediatric study has found a significant association between fat masses (especially intra-abdominal fat) and arterial wall thickness and stiffness in children ( 22 ).…”