title: Relationship of epicardial fat thickness with endothelial and cardiac functions in children with family history of type 2 diabetes mellitus.
abstract: OBJECTIVE
  We hypothesized that many of the pathophysiological mechanisms that cause atherosclerotic disease may be present in early childhood in children with family history of type 2 diabetes. We aimed to investigate the relation of epicardial fat thickness (EFT) with flow-mediated dilatation (FMD) and diastolic function in children with family history of type 2 diabetes mellitus.
  
  
  METHODS
  We measured EFT, FMD, in 209 children (mean age 8.6 + 3.2 years). Children were classified into 2 groups: 109 children with a family history of type 2 diabetes (group at risk) and 100 healthy children with age and body mass index matched and without parental history of diabetes constituted the control group.
  
  
  RESULTS
  Epicardial fat thickness was significantly increased in group at risk compared with control children (P < 0.001), while FMD was significantly lower in group at risk versus controls (P < 0.001). EFT was inversely correlated with FMD (r = -0.46; P < 0.001), while it was positively correlated with E/E' (r = 0.48; P < 0.001) and hsCRP (r = 0.39; P < 0.001). Receiver-operating characteristic curve analysis revealed a cutoff value of 5 mm for EFT can predict endothelial dysfunction in children with family history of DM area under the curve (AUC = 0.852) with a specificity of 92.2% and a sensitivity of 77.4%.
  
  
  CONCLUSIONS
  Our results suggest that children with family history of type 2 diabetes bear considerably impaired FMD% and diastolic dysfunction associated with increased EFT, that reflecting process that promote the development of cardiovascular disease (CVD).
authors.affiliation: Cardiology Department, Zagazig University Hospital, Zagazig, Egypt.
authors.forename: Ragab A
authors.initials: RA
authors.lastname: Mahfouz
authors.forename: Ahmad
authors.initials: A
authors.lastname: Alzaiat
authors.forename: Ahmad
authors.initials: A
authors.lastname: Yousry
mesh_terms: D000273:Adipose Tissue / Q000000981:diagnostic imaging*; D050154:Adiposity; D002648:Child; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000235:genetics*; D004452:Echocardiography / Q000706:statistics & numerical data; D004534:Egypt / Q000453:epidemiology; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D010496:Pericardium / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000453:epidemiology*
keywords: children; endothelial function; epicardial fat; type 2 diabetes