Can Epicardial Adipose Tissue be Defined as an Early Marker of Treatment Decisions of Subclinical Hypothyroidism in Childhood?

Introduction and Aim: Childhood overt hypothyroidism is a chronic disease that affect many system adversely and requires treatment. However, Subclinical Hypothyroidism (SH) ,defined obvious cases, impacts on other systems are unknown and there is no common approach to be treated. Moreover, SH may continue for many years, before they become overt hypothyroidism. Cardiovascular System (CVS) is one of the host system, which hypothyroidism adversely affects. Epicardial Adipose Tissue thickness (EAT) is known to be an important marker in terms of the cardiovascular risks. We aimed to determine the effects on CVS in children with SH. Material and Methods: The study included were 100 cases, which are 1-18 years had categorized in two groups; control group (50 children), who had no signs of thyroidal dysfunction and case group (50 children) who had diagnosed with SH, are recruited in the study. SH was diagnosed according to the slightly higher TSH than the upper limit (4.2M/L), normal free T4 and T3 levels. Medical Treatment (LT4) was decided according to the levels of TSH, sT3, sT4 and clinical status. EAT was determined by transthoracic echocardiographic measurements in millimeters. The SH cases were classified into two groups in terms of medical treatment. EAT thickness was measured in patients with treated group (SH1) and non-treated group (SH2) at admission (EAT0) and at 6. months (EAT 6). Results: Epicardial adipose tissue thickness was significantly higher in SH children, than the children without thyroid dysfunction. The mean value of the EAT in control group was 2,11 ± 0,52mm. Mean of EAT0 was 4,08 ± 1,41 in group SH1, mean of EAT0 was 4,31 ± 1,09mm in group SH2. In addition, mean of EAT6 was 3.65 ± 1,27mm in group SH1 and mean of EAT6 was 4,16 ± 1,10 in group SH2. Although there were a decrease in both group SH1 and SH2, at EAT6 compared to the EAT0, and this decrease was more significant in group SH1. Discussion: This study suggests that subclinical hypothyroidism effects adversly the cardiovascular system in children before hypothyroidism become overt. In future this data may be marker at the begining of LT4 treatment in children with SH.

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Can Epicardial Adipose Tissue be Defined as an Early Marker of Treatment Decisions of Subclinical Hypothyroidism in Childhood?

10.26420/jpediatriendocrinol.2021.1041 ◽

2021 ◽

Vol 6 (1) ◽

Author(s):

Asik G ◽

◽

Ergur AT ◽

Sanli C ◽

◽

...

Keyword(s):

Adipose Tissue ◽

Medical Treatment ◽

Subclinical Hypothyroidism ◽

Epicardial Adipose Tissue ◽

Treated Group ◽

Control Group ◽

Overt Hypothyroidism ◽

Case Group ◽

Tissue Thickness ◽

Epicardial Adipose Tissue Thickness

Introduction and Aim: Childhood overt hypothyroidism is a chronic disease that affect many system adversely and requires treatment. However, Subclinical Hypothyroidism (SH), defined obvious cases, impacts on other systems are unknown and there is no common approach to be treated. Moreover, SH may continue for many years, before they become overt hypothyroidism. Cardiovascular System (CVS) is one of the host system, which hypothyroidism adversely affects. Epicardial Adipose Tissue Thickness (EAT) is known to be an important marker in terms of the cardiovascular risks. We aimed to determine the effects on CVS in children with SH. Material and Methods: The study included were 100 cases, which are 1-18 years had categorized in two groups; control group (50 children), who had no signs of thyroidal dysfunction and case group (50 children) who had diagnosed with SH, are recruited in the study. SH was diagnosed according to the slightly higher TSH than the upper limit (4.2M/L), normal free T4 and T3 levels. Medical treatment (LT4) was decided according to the levels of TSH, sT3, sT4 and clinical status. EAT was determined by transthoracic echocardiographic measurements in millimeters. The SH cases were classified into two groups in terms of medical treatment. EAT thickness was measured in patients with treated group (SH1) and non-treated group (SH2) at admission (EAT0) and at 6 months (EAT 6). Results: Epicardial adipose tissue thickness was significantly higher in SH children, than the children without thyroid dysfunction. The mean value of the EAT in control group was 2,11±0,52 mm. Mean of EAT0 was 4,08±1,41 in group SH1, mean of EAT0 was 4,31±1,09 mm in group SH2. In addition, mean of EAT6 was 3.65±1,27 mm in group SH1 and mean of EAT6 was 4,16±1,10 in group SH2. Although there were a decrease in both group SH1 and SH2, at EAT6 compared to the EAT0, and this decrease was more significant in group SH1.

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The Association between Subclinical Hypothyroidism and Epicardial Adipose Tissue Thickness

Korean Circulation Journal ◽

10.4070/kcj.2015.45.3.210 ◽

2015 ◽

Vol 45 (3) ◽

pp. 210 ◽

Cited By ~ 1

Author(s):

Erdal Belen ◽

Aleks Değirmencioğlu ◽

Ertuğrul Zencirci ◽

Fatih Fahri Tipi ◽

Özgür Altun ◽

...

Keyword(s):

Adipose Tissue ◽

Subclinical Hypothyroidism ◽

Epicardial Adipose Tissue ◽

Tissue Thickness ◽

Epicardial Adipose Tissue Thickness

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The Relationship between Epicardial Adipose Tissue Thickness and Serum Interleukin-17a Level in Patients with Isolated Metabolic Syndrome

Biomolecules ◽

10.3390/biom9030097 ◽

2019 ◽

Vol 9 (3) ◽

pp. 97 ◽

Cited By ~ 4

Author(s):

Esra Demir ◽

Nazmiye Harmankaya ◽

İrem Kıraç Utku ◽

Gönül Açıksarı ◽

Turgut Uygun ◽

...

Keyword(s):

Insulin Resistance ◽

Metabolic Syndrome ◽

Adipose Tissue ◽

Epicardial Adipose Tissue ◽

Control Group ◽

Model Assessment ◽

Tissue Thickness ◽

The Metabolic Syndrome ◽

Epicardial Adipose Tissue Thickness ◽

The Relationship

In this study, it was aimed to investigate the relationship between the epicardial adipose tissue thickness (EATT) and serum IL-17A level insulin resistance in metabolic syndrome patients. This study enrolled a total of 160 subjects, of whom 80 were consecutive patients who applied to our outpatient clinic and were diagnosed with metabolic syndrome, and the other 80 were consecutive patients who were part of the control group with similar age and demographics in whom the metabolic syndrome was excluded. The metabolic syndrome diagnosis was made according to International Diabetes Federation (IDF)-2005 criteria. EATT was measured with transthoracic echocardiography (TTE) in the subjects. IL-17A serum levels were determined using the ELISA method. Fasting blood glucose, HDL, triglyceride, and fasting insulin levels were significantly higher in the metabolic syndrome group compared to the control group. In addition, the metabolic syndrome group had significantly higher high-sensitivity C-reactive protein (hs-CRP) and Homeostatic Model Assessment Insulin Resistance (HOMA-IR) levels than the control group. Similarly, serum IL-17A levels were significantly elevated in the metabolic syndrome group compared to the control group statistically (p < 0.001). As well, EATT was higher in the metabolic syndrome than the control group. Conclusion: By virtue of their proinflammatory properties, EATT and IL-17 may play an important role in the pathogenesis of the metabolic syndrome.

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The Association between the Epicardial Adipose Tissue Thickness and Oxidative Stress Parameters in Isolated Metabolic Syndrome Patients: A Multimarker Approach

International Journal of Endocrinology ◽

10.1155/2014/954045 ◽

2014 ◽

Vol 2014 ◽

pp. 1-9 ◽

Cited By ~ 5

Author(s):

Bulent Demir ◽

Esra Demir ◽

Gonul Acıksarı ◽

Turgut Uygun ◽

Irem Kırac Utku ◽

...

Keyword(s):

Oxidative Stress ◽

Metabolic Syndrome ◽

Adipose Tissue ◽

Epicardial Adipose Tissue ◽

Serum Levels ◽

Control Group ◽

Tissue Thickness ◽

Oxidative Stress Parameters ◽

Epicardial Adipose Tissue Thickness ◽

Stress Parameters

The risk for cardiovascular diseases and type 2 diabetes mellitus significantly increases in the patient population with metabolic syndrome (MeS). The present study aimed to investigate the association between the epicardial adipose tissue thickness (EATT) and the oxidative stress parameters in MeS patients. The study included 181 patients as a patient group of 92 consecutive patients with MeS and a control group of 89 consecutive patients with similar age and gender. EATT was evaluated by transthoracic echocardiography. Serum levels of total oxidant status (TOS), total antioxidative capacity (TAS), paraoxonase-1 (PON-1), and arylesterase activities were measured. EATT was higher in the MeS group compared to the control group (6.0 ± 2.0 mm and4.0 ± 1.0 mm, resp.;P<0.001). The level of TOS was higher in the MeS group compared to the control group (P<0.001). Additionally, the TAS level was higher in the MeS group compared to the control group (P<0.001). Furthermore, the serum levels of PON-1 and arylesterase were lower in the MeS group compared to the control group (P<0.001). EAT may cause an increased risk of cardiovascular diseases by leading to increased oxidative stress in patients with MeS.

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Effects of Semaglutide Versus Dulaglutide on Epicardial Fat Thickness in Subjects with Type 2 Diabetes and Obesity

Journal of the Endocrine Society ◽

10.1210/jendso/bvz042 ◽

2020 ◽

Vol 4 (4) ◽

Cited By ~ 4

Author(s):

Gianluca Iacobellis ◽

Alexandra C Villasante Fricke

Keyword(s):

Type 2 Diabetes ◽

Adipose Tissue ◽

Epicardial Adipose Tissue ◽

Statistical Significance ◽

Control Group ◽

Medication Regimen ◽

Tissue Thickness ◽

Receptor Agonists ◽

Epicardial Adipose Tissue Thickness

Abstract Background and Aims Epicardial adipose tissue (EAT), the visceral fat depot of the heart, is a modifiable cardio-metbolic risk factor and therapeutic target. Semaglutide and dulaglutide, glucagon-like peptide-1 (GLP-1) receptor agonists, are indicated for the treatment of type 2 diabetes mellitus (T2DM). GLP-1 receptor agonists have recently shown to reduce cardiovascular risk. Epicardial adipose tissue expresses GLP-1 receptors (GLP-1Rs). GLP-1 receptor agonist liraglutide is known to significantly decrease EAT thickness. However, the effects of GLP-1 receptor agonists semaglutide and dulaglutide on EAT thickness are unknown. Materials and Methods We performed a 12-week, controlled, parallel study in 80 subjects with T2DM and obesity. Patients received either semaglutide, up to 1 mg subcutaneous (sc) weekly, or dulaglutide, up to 1.5 mg sc weekly, as the standard of care in addition to their usual medication regimen. Twenty subjects with T2DM and obesity were started on metformin and a diet and served as the control group. Ultrasound-measured EAT thickness was measured at baseline and at the 12-week follow-up. Results Epicardial adipose tissue thickness significantly decreased in both semaglutide and dulaglutide groups (P < 0.001) after 12 weeks, accounting for a 20% reduction. There was no EAT reduction in the metformin group. Body mass index (BMI) and HbA1c improved in all groups without reaching statistical significance. Epicardial adipose tissue thickness reduction was significantly greater (P < 0.01) with the higher doses of semaglutide (1 mg) and dulaglutide (1.5 mg), respectively. Conclusion Weekly administration of either GLP-1 receptor agonists semaglutide or dulaglutide causes a rapid, substantial, and dose-dependent reduction in EAT thickness.

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Investigation of the effect of epicardial adipose tissue thickness on cardiac conduction system in children with type 1 diabetes mellitus

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem-2020-0001 ◽

2020 ◽

Vol 33 (6) ◽

pp. 713-720

Author(s):

Ahmet Yasin Güney ◽

Fatih Şap ◽

Beray Selver Eklioğlu ◽

Mehmet Burhan Oflaz ◽

Mehmet Emre Atabek ◽

...

Keyword(s):

Adipose Tissue ◽

Patient Group ◽

Epicardial Adipose Tissue ◽

Qt Dispersion ◽

Conduction System ◽

Cardiac Conduction ◽

Control Group ◽

Tissue Thickness ◽

Epicardial Adipose Tissue Thickness

AbstractObjectivesInvestigation of the association between epicardial adipose tissue thickness (EATT) and P-wave dispersion (Pd), QT dispersion (QTd), corrected QT dispersion (QTcd) and Tp-e interval in children with Type 1 Diabetes Mellitus (T1DM) was aimed.MethodsForty-one children with T1DM and 41 age- and gender-matched healthy children were included in the study. Demographical characteristics of all cases were examined. In echocardiography; in addition to conventional echocardiographic measurements, end-systolic EATT was measured from right ventricular free wall. In electrocardiogram; Pd, QTd, QTcd and Tp-e interval durations, as well as Tp-e/QT and Tp-e/QTc ratios were calculated. Correlation values between EATT and electrocardiographic parameters were also noted.ResultsMean age of the patient group was determined to be 12.43 ± 3.04 years and that of the control group was determined to be 12.08 ± 2.56 years. There was no significant difference between the groups in regard to age, gender, body weight, height and body mass index. In the patient group; EATT, Pd, QTd, QTcd and Tp-e interval were determined to be significantly higher compared to the control group. In the patient group, no significant correlation was determined between EATT and Pd, QTd, QTcd and Tp-e. However, when both patient and control groups were evaluated together, a statistically significant positive correlation was determined between EATT and Pd, QTd, QTcd and Tp-e.ConclusionsIn children with T1DM, an increase in epicardial adipose tissue thickness and in risk of cardiac arrhythmias has been demonstrated. To reveal the possible unfavorable effects of EATT on cardiac conduction system in T1DM patients needs further studies.

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