Key result
Obesity treatment cuts epicardial adipose tissue by ~13% in children with successful weight reduction.
Why the study?
Epicardial adipose tissue is proposed as a unique cardiovascular risk marker, yet its role in early cardiovascular disease development and response to childhood obesity treatment remains poorly understood.
Does initiation of obesity treatment reduce epicardial adipose tissue (EAT) in children aged 10-14 years with obesity?
Observational (n=150)
Does initiation of obesity treatment reduce epicardial adipose tissue (EAT) in children aged 10-14 years with obesity?
Epicardial adipose tissue is significantly elevated in children with obesity and correlates with cardiometabolic risk markers, but decreases over 18 months following obesity treatment initiation regardless of the magnitude of BMI-SDS reduction.
Answers are grounded in this paper and cite their sources.
Supports epicardial adipose tissue as a modifiable marker in pediatric obesity, though routine MRI should not yet change practice; leaves open its impact on long-term outcomes.
Background Epicardial adipose tissue (EAT) is proposed as a unique cardiovascular risk marker in both adults and children, yet its role in early cardiovascular disease development remains poorly understood. Since childhood obesity significantly increases the risk of adult cardiovascular mortality, a deeper understanding of early markers like EAT could improve prevention strategies. Purpose We aimed to (1) quantify EAT in children with and without obesity, (2) assess correlations with cardiometabolic parameters and measures of adiposity, and (3) evaluate changes in EAT following initiation of obesity treatment. Methods In this longitudinal observational study, we included 100 children aged 10-14 years at initiation of obesity treatment and 50 population-based controls with normal weight. EAT was quantified at baseline and after 18 months by magnetic resonance imaging (MRI) on 4-chamber cines. Anthropometrics, blood samples, dual-energy x-ray absorptiometry (DXA), and MRI of the thorax and abdomen were obtained. Results At baseline, EAT was 40% higher in children with obesity (BMI-SDS 3.09±0.58) compared to normal-weight controls (BMI-SDS 0.10±0.94). EAT correlated positively with weight, waist circumference, body mass index (BMI), plasma triglycerides, visceral adipose tissue (VAT) and total body fat percentage, even when adjusting for sex, BMI standard deviation score (BMI-SDS) and height. Follow-up data was available for 93 children. When stratified by BMI-SDS reduction of 0.25, those with BMI-SDS reduction ≥0.25 had a 13% (p=0.002) reduction in EAT, while those with BMI-SDS reduction <0.25 had a 10% reduction in EAT (p=0.012) at follow-up. No significant difference in EAT reduction was observed between subgroups. Conclusion EAT is elevated in children with obesity and correlates with cardiometabolic risk markers. Notably, EAT decreased following initiation of obesity treatment regardless of the degree of BMI-SDS reduction, suggesting that factors beyond obesity reduction may contribute to EAT reduction.
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Groth et al. (2026) conducted an observational in Childhood obesity (n=150). Childhood obesity and initiation of obesity treatment vs. Normal-weight controls / BMI-SDS reduction <0.25 was evaluated on Epicardial adipose tissue (EAT) quantified by MRI and percentage reduction after 18 months (p=0.002). Children with obesity had 40% higher epicardial adipose tissue vs controls, and obesity treatment reduced it by 13% (p=0.002) and 10% (p=0.012) for BMI-SDS reductions ≥0.25 and <0.25.
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