Introduction: Pediatric metabolic syndrome (MS) cor-relates with cardiac structural and geometrical changes and also correlates with asymptomatic coronary atherosclerosis. Epicardial adipose tissue (EAT) is considered a predictor of this syndrome and a risk marker of cardiovascular disorders, being associated with subclinical coronary disease among pediatric population.

Objective: To study the echocardiographic parameters of EAT thickness (T) and its correlative analysis with the anthropometric, hemodynamic, metabolic, and cardiovascular remodeling parameters.

Methods: A observational analytical cohort study. This study enrolled a total of 118 children (aged 10-18 years; 63 boys and 55 girls; 45 with MS, and 73 with non-MS). The diagnosis of MS was established according to the International Diabetes Federation criteria. EATT was measured with transthoracic echocardiography in the subjects. Statistical Analysis Used – SPSS version 20. Ethical Issues – the research was approved by the Re-search Ethics Committee of „Nicolae Testemitanu“ Sta-te University of Medicine and Pharmacy.

Results: Depending on the presence / absence of the MS, the mean value of the EATT was beyond the accepted cut-off points both in the main study and control group (5.39 ± 0.22mm vs. 4.97 ± 0.17mm; p> 0.05). According to the number of MS components, the study participants showed an increasing tendency in EATT value depending upon the number of MS components, thus being higher in subjects with three, four or five components, compared to those with a single compo-nent, but not for two components (5.30 ± 0.27mm vs 5.54 ± 0.4mm vs. 4.84 ± 0.28mm vs. 5.01 ± 0.22 mm; F= 0.96; p> 0.05). As regarding the distribution of the EATT mean values among the MS clusters, it was found to be higher in subjects with four and five positive criteria, respectively WC-HDLc-HBP= 5.47 ± 0.44mm vs. WC-TG-HBP= 5.6 ± 0.84mm vs. WC-TG-HDLc= 4.65 ± 0.38mm and WC-TG-HDLc-HBP= 5.77 52mm; F= 0.82; p> 0.05). There was a significant correlation between the EATT and body weight (r= 0.41*; p< 0.001), BMI (kg/m2/Z score) (r= +0.33*/r= +0.31*; p< 0.05), WC (r= 0.4*; p< 0.05), hip-to-waist ratio (r= +0.35*; p< 0.05), IVS (r= +0.3*; p< 0.05), left ventricular posterior wall (r= +0.34*; p< 0.05) and left ventricular mass (r= +0.3*; p< 0.05)

Conclusions: The ultrasound imaging of EATT exceeded the admitted cut-off point values in children with MS, showing a tendency to increase depending on the number of risk factors, as wel as higher values were present in the clinical forms, which mainly contain obesity, HDLc and HBP. The positive linear correlation of the EATT with the anthropometric parameters (weight, BMI, WC and waist-to-hip index) indicates that it is a good indicator of visceral fat, whereas the correlation with cardiac remodeling values (IVS, LVPW and LV Mass) suggested that it is associated with a consensual and proportional progression of left ventricular structural changes.

Note: WC – waist circumference; HDLc – High-density lipoprotein cholesterol, TG – triglycerides, HBP – high blood pressure, Glu – glucose.