title: Epicardial fat thickness: threshold values and lifestyle association in male adolescents.
abstract: BACKGROUND
  Obese adolescents with high proportion of visceral fat are at higher risk of developing the metabolic syndrome.
  
  
  OBJECTIVE
  The study aims to investigate if echocardiographic epicardial fat thickness (EF) could be predictive of visceral obesity (VO) early in life and to provide EF threshold values specific for male adolescents. Further aim was to investigate the association between EF, lifestyle and metabolic disease familiarity.
  
  
  METHODS
  Anthropometric data were collected from 102 normal weight and overweight, healthy male adolescents (mean age: 14.91 ±  1.98 years); bioelectrical impedance analysis and transthoracic echocardiogram were performed in the same sample. Each participant fulfilled a validated self-administered lifestyle questionnaire.
  
  
  RESULTS
  We found higher EF values in sedentary adolescents (P < 0.05), in those who never eat fruit and vegetables (P < 0.05), and in those with overweight mothers (P < 0.05). The strongest independent predictor of EF was waist circumference (P < 0.0001). Using the waist to height ratio as a marker of VO, logistic regression analysis revealed that 1 mm EF gain is responsible for seven times higher VO risk (P < 0.0001). Receiver Operating Characteristic (ROC) analysis showed that the optimal cut-off for EF thickness associated to youth VO is 3.2 mm.
  
  
  CONCLUSIONS
  Ultrasonography EF measurement might be a second-level assessment tool, useful to detect early cardiometabolic damage stage.
authors.affiliation: Department of Public Health, Experimental and Forensic Medicine - Unit of Human Nutrition, University of Pavia, Pavia, Italy.
authors.forename: H
authors.initials: H
authors.lastname: Cena
authors.forename: M L
authors.initials: ML
authors.lastname: Fonte
authors.forename: P M
authors.initials: PM
authors.lastname: Casali
authors.forename: S
authors.initials: S
authors.lastname: Maffoni
authors.forename: C
authors.initials: C
authors.lastname: Roggi
authors.forename: G
authors.initials: G
authors.lastname: Biino
mesh_terms: D000293:Adolescent; D001794:Blood Pressure; D001823:Body Composition; D015444:Exercise; D006801:Humans; D050152:Intra-Abdominal Fat / Q000473:pathology*; D007558:Italy / Q000453:epidemiology; D008019:Life Style; D008297:Male; D009035:Mothers; D009765:Obesity / Q000453:epidemiology / Q000473:pathology* / Q000517:prevention & control; D010496:Pericardium / Q000473:pathology*; D012307:Risk Factors; D011795:Surveys and Questionnaires; D055105:Waist Circumference
keywords: Adolescent obesity; epicardial fat; lifestyle; visceral fat