Ultrasound evaluation of epicardial fat and Eco-Obesity body composition assessment.

The majority of patients with obesity had moderate or severe epicardial adipose tissue thickness.

• Moderate EAT thickness (>7mm) was found in 35.6% of patients.
• Severe EAT thickness (>10mm) was found in 53.1% of patients.
• The study included 402 adults with obesity attending two Barcelona centers.
• Eco-Obesity ultrasound was performed in 114 subjects alongside DEXA scans.

EAT measured across multiple echocardiographic projections correlated significantly with anthropometric indices of obesity.

• EAT measured in long-axis, short-axis, and posterior cardiac recess (PPR) projections all correlated significantly with BMI, waist circumference, and waist-to-height ratio (all p<0.02).
• The EAT long-axis projection showed the strongest and most consistent correlations with anthropometric and DEXA visceral fat indices.
• EAT was also associated with omental and peri-renal fat compartments.

EAT measurements were associated with markers of metabolic dysfunction including glycemia, insulin resistance, and lipid profiles.

• EAT PPR correlated positively with glycemia, HOMA-IR, and triglycerides, and negatively with HDL cholesterol.
• EAT long-axis and short-axis projections also correlated with glycemia and HOMA-IR.
• These relationships were identified through Pearson correlation analysis.

Omental fat showed the strongest associations with glycemic and insulin resistance markers among all abdominal fat depots.

• Omental fat exhibited the strongest associations with glycemia, HOMA index, and HbA1c.
• Omental fat correlated significantly with anthropometric and DEXA visceral fat indices.
• Peri-renal fat showed a significant positive association with fasting glycemia and an inverse association with HDL.

Pre-peritoneal fat did not correlate significantly with anthropometric or DEXA visceral fat indices, unlike omental and peri-renal fat.

• Omental and peri-renal fat layers correlated significantly with anthropometric and DEXA visceral fat.
• Pre-peritoneal fat did not show such correlations.
• This distinction was made using Pearson correlation coefficients and subgroup comparisons by ANOVA.

The Eco-Obesity ultrasound protocol assessed multiple fat depots including epicardial, preperitoneal, omental, and peri-renal fat in comparison with DEXA-derived body composition.

• A cross-sectional study design was used with 402 adults with obesity at two Barcelona centers.
• 114 subjects underwent both Eco-Obesity ultrasound and DEXA scans.
• Standardized protocols were used for measurement of thickness of epicardial and abdominal fat depots, metabolic markers, and anthropometric indices.
• Relationships were analyzed by Pearson correlation coefficients; subgroup comparisons used ANOVA.