Evaluation of Early Diagnostic Methods for Subclinical Cardiovascular Changes in Childhood Obesity.

Childhood obesity is associated with early cardiometabolic abnormalities and subclinical vascular and cardiac changes. This narrative review summarizes the mechanisms underlying these changes and evaluates non-invasive methods used for early detection. PubMed/MEDLINE and Scopus were searched for pediatric studies, systematic reviews, and guidelines, and the principal evidence sources were appraised using design-appropriate tools. Blood pressure measurement, anthropometry, and age-and risk-based laboratory testing remain the basis of routine assessment. Carotid intima-media thickness, pulse wave velocity, endothelial function tests, heart rate variability, advanced echocardiographic measures, and epicardial adipose tissue assessment are promising; however, methodological heterogeneity and limited pediatric reference values restrict most of them to selected clinical or research settings. Standardized longitudinal studies are required to validate thresholds and determine whether test-guided strategies improve outcomes.