The impact of hepatic steatosis on epicardial adipose tissue in obese individuals

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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 non-alcoholic fatty liver disease (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 right ventricular diastolic diameter (RVDD) and interventricular septal thickness in diastole (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.