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ISSN: 0031-3939
Pediatria Polska - Polish Journal of Paediatrics
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4/2023
vol. 98
 
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abstract:
Original paper

Role of epicardial fat thickness and irisin levels in early prediction of cardiac dysfunction in children and adolescents with type 1 diabetes mellitus

Abeer M. Nour ElDin Abd ElBaky
1
,
Nagwa Abdallah Ismail
1
,
Azza M.O. AbdelRahman
1
,
Sally A.F. EL-Sahrigy
1
,
Rasha M. Hasanin
1
,
Hoda H. Ahmed
1
,
Maha M.A. Abo Hashesh
1
,
Mona Hamed Ibrahim
2

  1. Department of Paediatrics, Medical Research and Clinical Studies Institute, National Research Centre, Cairo, Egypt
  2. Department of Clinical and Chemical Pathology, Medical Research and Clinical Studies Institute, National Research Centre, Cairo, Egypt
Pediatr Pol 2023; 98 (4): 278-284
DOI: https://doi.org/10.5114/polp.2023.133530
Online publish date: 2023/12/15
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Introduction
to assess the role of epicardial fat thickness and irisin in early prediction of cardiac dysfunction in children and adolescents with type 1 diabetes mellitus and correlate them with echocardiographic parameters and lipid profile.

Material and methods
Sixty-three type 1 diabetic children and adolescents were recruited from the Pediatric Diabetic Clinic, National Research Centre. Thirty-four healthy children, matched for age and sex, served as controls. All patients were insulin dependent with at least 3-year duration of the disease since diagnosis. Venous blood was withdrawn under complete aseptic precautions from fasting subjects; sera were collected for evaluation of glycated haemoglobin (HbA1C), lipid profile and irisin levels. Two-dimensional echocardiography was performed for measurement of interventricular septal thickness in diastole, left atrial diameter (LAD), aortic root diameter, mitral E and A wave, left ventricular internal dimension in diastole, percent fractional shortening (FS%), percent ejection fraction, left ventricular mass, and epicardial fat thickness. Patients were further divided into two groups according to their glycaemic control (< 7.00, ≥ 7.0) for comparison of echocardiographic parameters and irisin.

Results
Echocardiographic study revealed a statistically significant increase in LAD, FS%, and epicardial fat thickness in patients compared to controls (p = 0.000, 0.014, and 0.000 respectively). Triglyceride and irisin levels were significantly increased in patients compared to controls (p = 0.012, 0.015 respectively). Epicardial fat thickness positively correlated with left atrial diameter (p = 0.009) and left ventricular mass (p = 0.000). Irisin was positively correlated with E/A ratio (p = 0.05).

Conclusions
The findings of the present study probably indicate the beginning of a state of metabolically induced diastolic dysfunction. Echocardiography should be performed in type 1 diabetic patients on a regular basis for early detection of subclinical cardiac dysfunction.

keywords:

epicardial fat thickness, type 1 diabetes mellitus, cardiac dysfunction, children