Original Article

Epicardial and Perihepatic Fat as Cardiometabolic Risk Predictors in Girls with Turner Syndrome: A Cardiac Magnetic Resonance Study


  • Nanees A. Salem
  • Nihal M. Batouty
  • Ahmed M. Tawfik
  • Donia M. Sobh
  • Basma Gadelhak
  • Shimaa R. Hendawy
  • Wafaa Laimon

Received Date: 28.01.2021 Accepted Date: 19.05.2021 J Clin Res Pediatr Endocrinol 0;0(0):0-0 [e-Pub] PMID: 34013713


Turner syndrome (TS) patients are at high risk of cardiometabolic disorders. Cardiometabolic risk factors are more related to visceral rather than total body adiposity. Adipocytokines have been explored as a potential link between obesity and obesity-related cardiometabolic dysfunctions. We explored the validity of epicardial fat-thickness (EFT) and perihepatic fat-thickness (PHFT) as cardiometabolic-risk predictors in TS-girls in relation to standard obesity-indices and metabolic syndrome (MetS) components.


Forty-six TS girls and twenty-five controls (10-16 years) were subdivided into two age-groups (10-13 and 13-16). They were assessed for BMI-Z-scores, waist-circumference (WC), total-fat mass (FM) and trunk-FM by bioimpedance-technique, EFT and PHFT by cardiovascular magnetic resonance, lipid-profile, Homeostasis model assessment of insulin resistance (HOMA-IR), and serum chemerin. MetS was defined according to International Diabetes Federation criteria.


Overweight/obesity and MetS were detected in 45.7% and 37% of TS-girls respectively. BMI-Z-score, WC, total-FM, trunk-FM, EFT and PHFT values were significantly higher in TS-age groups compared to age-matched control groups, being more pronounced in older group at which TS-girls eventually exposed to estrogen. Dyslipidemia, higher HOMA-IR, chemerin, EFT and PHFT values were observed in lean-Turner compared to BMI-Z-matched controls. EFT and PHFT were significantly correlated with chemerin and several components of MetS. EFT at a cutoff-value of 6.20 mm (AUC=0.814) can predict MetS in TS-girls.


TS-girls displayed adverse cardiometabolic profile during late childhood and adolescence. EFT and PHFT are emerging cardiometabolic risk predictors in TS-patients. Excess EFT rather than total body adiposity may contribute to altered metabolic profile among lean-Turner patients.

Keywords: Epicardial fat, Perihepatic fat, metabolic syndrome, Turner Syndrome