Key result
Waist circumference above the 90th percentile predicts pathological epicardial fat in overweight and obese youth.
Why the study?
Overweight and obesity in childhood promote cardiovascular risk, and the study aimed to establish whether waist circumference could predict cardiovascular complications in children.
Does waist circumference predict cardiovascular complications in overweight and obese children and adolescents?
Observational (n=160)
No
Does waist circumference predict cardiovascular complications in overweight and obese children and adolescents?
Effect estimate: AUC 0.668 (95% CI 0.562-0.775)
Absolute Event Rate: 21.74% vs 2.17%
p-value: p=0.014
Waist circumference above the 90th percentile predicts increased left ventricular mass index and concentric hypertrophy in overweight and obese children and adolescents.
Waist circumference may flag pathological epicardial fat in obese youth; hypothesis-generating and requires prospective validation for cardiovascular outcomes.
Overweight and obesity in childhood are associated with early cardiovascular dysfunction and promote heightened risk of cardiovascular morbidity and mortality in adulthood. Waist circumference (WC) correlates with visceral obesity, which is why obese children with elevated WC need to be carefully monitored to prevent long-term cardio-metabolic complications. The purpose of our study was to establish if WC could be a predictor of cardiovascular complications in children.The authors conducted a retrospective study that included 160 overweight and obese children and adolescents, aged 6 to 18 years. Patients were evaluated completely anthropometrically, biologically, and imagistic. The anthropometric data tracked were height, weight, WC, and body mass index. Echocardiography evaluated the following parameters: the interventricular septum, left ventricular mass, the relative thickness of the ventricular wall, the pathological epicardial fat.Our results confirm that the presence of visceral obesity was significantly associated (χ = 11.72, P = .0006) with pathological epicardial fat. In children, visceral obesity is not a risk factor for vascular or cardiac impairment, but in adolescents, the results showed that visceral obesity is an important predictive factor for the occurrence of vascular (AUC = 0.669, P = .021) and cardiac (AUC = 0.697, P = .037) impairment. Concentric left ventricular (LV) hypertrophy is significantly influenced by the presence of visceral obesity (AUC = 0.664, P = .013 children; AUC = 0.716, P = .026 adolescents).WC above the 90th percentile is a predictive factor for increased LVM index and concentric hypertrophy in both children and adolescents.
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Trandafir et al. (2020) conducted an observational in Overweight and obesity (n=160). Visceral obesity (waist circumference >90th percentile) vs. Absence of visceral obesity was evaluated on Pathological epicardial fat (AUC 0.668, 95% CI 0.562-0.775, p=0.014). Visceral obesity, indicated by waist circumference above the 90th percentile, significantly predicted the presence of pathological epicardial fat (AUC 0.668) in overweight and obese children and adolescents.
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