Assessment of Epicardial Fat Thickness in Infants of Diabetic Mothers and its Relation to Glycated Albumin Level

Authors

  • Rania Mohamed Abdou Pediatrics Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
  • Nehal Mohamed El Raggal Pediatrics Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
  • Rania Ashraf Yehia Mansour Elsayed Pediatrics Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
  • Nanies Mohammed Salah Eldin Pediatrics Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt

DOI:

https://doi.org/10.6000/1929-4247.2025.14.03.12

Keywords:

Epicardial fat thickness, Glycated albumin, Infants of diabetic mothers, Gestational diabetes, Neonatal cardiometabolic risk, Echocardiography, Short-term glycemic control

Abstract

Background: Infants of diabetic mothers (IDMs) are at increased risk for developing cardiometabolic disorders. Traditional markers like HbA1c have limitations in certain clinical scenarios, highlighting the need for alternative indicators. Epicardial fat thickness (EFT), due to its anatomical and functional proximity to the heart, and glycated albumin, a short-term glycemic marker, may provide early risk detection.

Objective: To assess epicardial fat thickness and umbilical cord glycated albumin levels in neonates of diabetic mothers and determine their association, exploring their potential as early predictors of short-term glycemic control and cardiometabolic risk.

Methods: This cross-sectional, case-control study involved 35 IDMs and 30 neonates born to non-diabetic mothers (NIDMs). Echocardiography measured EFT in the first week of life, while glycated albumin was measured via ELISA from umbilical cord blood. Statistical analysis included ROC curves and logistic regression to evaluate diagnostic performance.

Results: EFT and glycated albumin were significantly elevated in IDMs compared to NIDMs (p < 0.001). A cutoff value of EFT >16.3 mm had a specificity of 93.1% and a sensitivity of 54.29%. Glycated albumin>434 g/dl showed a sensitivity of 91.43% and specificity of 83.33%. Multivariate analysis identified glycated albumin as a strong independent predictor of pregestational diabetes mellitus, while both biomarkers were associated with gestational diabetes.

Conclusions: EFT and glycated albumin serve as effective, non-invasive markers for early detection of cardiometabolic risk in neonates born to diabetic mothers. Their incorporation into routine assessments may enhance early diagnosis and targeted intervention strategies.

References

Shashikadze B, Flenkenthaler F, Stöckl JB, Valla L, Renner S, Kemter E, et al. Developmental effects of (pre-) gestational diabetes on offspring: systematic screening using omics approaches. Genes 2021; 12(12): 1991. DOI: https://doi.org/10.3390/genes12121991

Zendjabil M. Glycated albumin. Clin Chim Acta 2020; 502: 240-4. DOI: https://doi.org/10.1016/j.cca.2019.11.007

Xiong JY, Wang JM, Zhao XL, Yang C, Jiang XS, Chen YM, et al. Glycated albumin as a biomarker for diagnosis of diabetes mellitus: a systematic review and meta-analysis. World J Clin Cases 2021; 9(31): 9520. DOI: https://doi.org/10.12998/wjcc.v9.i31.9520

Raafat M, Aborizk S, Saraya M, Soliman HH. Role of fetal echocardiography in morphologic and functional assessment of fetal heart in diabetic mothers. Egypt J Radiol Nucl Med 2020; 51: 84. DOI: https://doi.org/10.1186/s43055-020-00207-0

Park MK. Pediatric cardiology for practitioners. Non-invasive techniques. In: Park MK, editor. 5th ed. Philadelphia: Elsevier; Chap. 6.

Iacobellis G, Willens HJ. Echocardiographic epicardial fat: a review of research and clinical applications. J Am Soc Echocardiogr 2009; 22(12): 1311-9. DOI: https://doi.org/10.1016/j.echo.2009.10.013

Villasante Fricke AC, Iacobellis G. Epicardial adipose tissue: clinical biomarker of cardio-metabolic risk. Int J Mol Sci 2019; 20(23): 5989. DOI: https://doi.org/10.3390/ijms20235989

Kohzuma T, Tao X, Koga M. Glycated albumin as biomarker: evidence and its outcomes. J Diabetes Complications 2021; 35(11): 108040. DOI: https://doi.org/10.1016/j.jdiacomp.2021.108040

Sever B, Bayraktar B, Adıyaman D, Gölbaşı H, Ömeroğlu İ, Çolak S, et al. Association of increased fetal epicardial fat thickness with maternal pregestational and gestational diabetes. J Matern Fetal Neonatal Med 2023. DOI: https://doi.org/10.22541/au.167282390.09821214/v1

Abd El Moktader AM, Yousef RM, Safwat A, Borayek HA. Epicardial fat thickness among neonates of diabetic mothers attending the neonatal intensive care unit at Fayoum University Hospital: a case-control study. Egypt Pediatr Assoc Gaz 2024; 72(1): 13. DOI: https://doi.org/10.1186/s43054-024-00254-6

Vela-Huerta MM, Amador-Licona N, Domínguez-Damián R, Heredia-Ruiz A, Orozco-Villagomez HV, Guízar-Mendoza JM, et al. Epicardial fat thickness in infants of diabetic mothers. J Neonatal Perinatal Med 2022; 15(1): 75-80. DOI: https://doi.org/10.3233/NPM-210787

Iskender C, Yakut Yücel K, Dereli ML, Sağlam E, Çelen Ş, Çağlar T, et al. Increased fetal epicardial fat thickness: a reflecting finding for GDM and perinatal outcomes. Echocardiography 2022; 39(8): 1082-8. DOI: https://doi.org/10.1111/echo.15416

Published

2025-08-01

How to Cite

Abdou, R. M. ., El Raggal, N. M. ., Mansour Elsayed, R. A. Y. ., & Salah Eldin, N. M. . (2025). Assessment of Epicardial Fat Thickness in Infants of Diabetic Mothers and its Relation to Glycated Albumin Level. International Journal of Child Health and Nutrition, 14(3), 321–328. https://doi.org/10.6000/1929-4247.2025.14.03.12

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Section

General Articles