Hostname: page-component-586b7cd67f-t7fkt Total loading time: 0 Render date: 2024-11-24T09:46:32.103Z Has data issue: false hasContentIssue false
  • English
  • Français

Comparison of echocardiographic findings with laboratory parameters in obese children

Published online by Cambridge University Press:  14 September 2015

Ozlem Korkmaz ,
Hazım A. Gursu  and
Barbaros S. Karagun
Ozlem Korkmaz
Affiliation:
Department of Pediatric Endocrinology, Sivas Numune Hospital, Sivas, Turkey
Hazım A. Gursu*
Affiliation:
Department of Pediatric Cardiology, Sivas Numune Hospital, Sivas, Turkey
Barbaros S. Karagun
Affiliation:
Department of Pediatric Hematology, Sivas Numune Hospital, Sivas, Turkey
*
Correspondence to: H. A. Gursu, MD, Department of Pediatric Cardiology, Sivas Numune Hospital, Sivas, Turkey. Tel: +90 3464444458 4604; Fax: +90 3462253939; E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Aim

The purpose of our study was to evaluate the association between insulin resistance and left ventricular size and function in obese children.

Material and methods

A total of 79 cases aged 10–16 years and diagnosed with obesity and 79 healthy and non-obese cases as controls were included in the study. Patient and control groups were divided into three groups in terms of age as group 1 (10–12 years), group 2 (12–14 years), and group 3 (14–16 years). Fasting blood glucose, lipid profile, and fasting insulin levels of the cases were assessed. Mitral valve E and A waves, left ventricular ejection fraction, fractional shortening, end-diastolic and end-systolic diameters, left atrium diameter, and septal wall thickness were measured using echocardiography.

Results

Measurements of septal diastolic thicknesses, left atrium diameter, and left ventricular end-systolic diameter of all the three groups obtained by echocardiography were statistically higher compared with the controls. In all the patient groups, the mitral valve E/A ratio was >1. In groups 2 and 3, there was a positive correlation between fasting insulin levels and HOMA-IR and left ventricular end-systolic diameter, end-diastolic diameter, and septal systolic and diastolic wall thicknesses.

Conclusion

In paediatric obesity, identification of early cardiac changes will be significant in allowing early diagnosis and treatment of cardiovascular diseases.

Keywords

Obesityechocardiographyleft ventricleinsulin
Type
Original Articles
Information
Cardiology in the Young , Volume 26 , Issue 6 , August 2016 , pp. 1060 - 1065
Check for updates
Copyright
© Cambridge University Press 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Ebbeling, CB, Pawlak, DB, Ludwig, DS. Childhood obesity: public-health crisis, common sense cure. Lancet 2002; 360: 473–482.Google Scholar
2. Flegal, KM, Troiano, RP. Changes in the distribution of body mass index of adults and children in the US population. Int J Obes 2000; 24: 807–818.Google Scholar
3. Tarım, O. Overview of pediatric obesity. Guncel Pediatri 2006; 4: 28–31.Google Scholar
4. Must, A, Jacques, PF, Dallal, GE, Bajema, CJ, Dietz, WH. Long-term morbidity and mortality of overweight adolescents: a follow-up of the Harvard Growth Study of 1922 to 1935. N Engl J Med 1992; 327: 1350–1355.Google Scholar
5. Franks, PW, Hanson, RL, Knowler, WC, Sievers, ML, Bennett, PH, Looker, HC. Childhood obesity, other cardiovascular risk factors, and premature death. N Engl J Med 2010; 362: 485–493.Google Scholar
6. Juonala, M, Magnussen, CG, Berenson, GS, et al. Childhood adiposity, adult adiposity, and cardiovascular risk factors. N Engl J Med 2011; 365: 1876–1885.Google Scholar
7. Kibar, AE, Paç, FA, Oflaz, MB, Ballı, S, Ece, I. Echocardiographic evaluation of left ventricular function in normotansive obese children: a comparative analysis according to body mass index. Arch Turk Soc Cardiol 2012; 40: 337–346.Google Scholar
8. Dayı, SU, Tartan, Z, Kasıkcıoglu, H, et al. Hypertension in obese women effects on cardiopulmonary functions. Arch Turk Soc Cardiol 2005; 33: 155–160.Google Scholar
9. Kajaia, N, Binder, H, Dittrich, R, et al. Low sex hormone-binding globulin as a predictive marker for insulin resistance in women with hyperandrogenic syndrome. Eur J Endocrinol 2007; 157: 499–507.Google Scholar
10. Zimmet, P, Alberti, KG, Kaufman, F, et al. The metabolic syndrome in children and adolescents: an IDF consensus report. Pediatr Diabetes 2007; 8: 229–306.Google Scholar
11. Sangun, O, Dundar, B, Kosker, M, Pirgon, O, Dundar, N. Prevalence of metabolic syndrome in obese children and adolescents using three different criteria and evaluation of risk factors. J Clin Res Pediatr Endocrinol 2011; 3: 70–76.Google Scholar
12. Edvardsen, T, Helle-Valle, T, Smiseth, OA. Systolic dysfunction in heart failure with normal ejection fraction: speckle-tracking echocardiography. Prog Cardiovasc Dis 2006; 49: 207–214.Google Scholar
13. Benjamin, EJ, D’Agostino, RB, Belanger, AJ, Wolf, PA, Levy, D. Left atrial size and the risk of stroke and death. The Framingham Heart Study. Circulation 1995; 92: 835–841.Google Scholar
14. Hirschler, V, Acebo, HL, Fernandez, GB, de Luján Calcagno, M, Gonzalez, C, Jadzinsky, M. Influence of obesity and insulin resistance on left atrial size in children. Pediatr Diabetes 2006; 7: 39–44.CrossRefGoogle ScholarPubMed
15. Juhola, J, Magnussen, CG, Viikari, JSA, et al. Tracking of serum lipid levels, blood pressure, and body mass index from childhood to adulthood: the cardiovascular risk in Young Finns Study. J Pediatr 2011; 159: 584–590.Google Scholar
16. Sasson, Z, Rasooly, Y, Bhesania, T, Rasooly, I. Insulin resistance is an important determinant of left ventricular mass in obese. Circulation 1993; 88: 1431–1436.Google Scholar
17. Berkalp, B, Cesur, V, Corapcioglu, D, Erol, C, Baskal, N. Obesity and left ventricular diastolic dysfunction. Int J Cardiol 1995; 10: 23–26.Google Scholar
18. Kono, Y, Yoshinaga, M, Oku, S, Nomura, Y, Nakamura, M, Aihoshi, S. Effect of obesity on echocardiographic parameters in children. Int J Cardiol 1994; 46: 7–13.Google Scholar
19. Daniels, SR, Witt, SA, Glascock, B, Khoury, PR, Kimball, TR. Left atrial size in children with hypertension: the influence of obesity, blood pressure, and left ventricular mass. J Pediatr 2002; 141: 186–190.Google Scholar
20. Mehta, SK, Holliday, C, Hayduk, L, Wiersma, L, Richards, N, Younoszai, A. Comparison of myocardial function in children with body mass indexes ≥25 versus those <25 kg/m2 . Am J Cardiol 2004; 93: 1567–1569.CrossRefGoogle ScholarPubMed
21. Garavaglia, GE, Messerli, FH, Nunez, BD, Schmieder, RE, Grossman, E. Myocardial contractility and left ventricular function in obese patients with essential hypertension. Am J Cardiol 1988; 62: 594–597.Google ScholarPubMed
22. Sermez, Y, Eren, O, Keskin, A, Turk, T. Left ventricular function in obese women and its correlating with body fat mass. Turkiye Klinikleri J Cardiol 1997; 10: 14–17.Google Scholar
23. Sasson, Z, Rasooly, Y, Gupta, R, Rasooly, I. Left atrial enlargement in healthy obese: prevalence and relation to left ventricular mass and diastolic function. Can J Cardiol 1996; 12: 257–263.Google Scholar
24. Di Bello, V, Santini, F, Di Cori, A, et al. Obesity cardiomyopathy: is it a reality? An ultrasonic tissue characterization study. J Am Soc Echocardiogr 2006; 19: 1063–1071.Google Scholar
25. Urheim, S, Edvardsen, T, Torp, H, Angelsen, B, Smiseth, OA. Myocardial strain by Doppler echocardiography. Validation of a new method to quantify regional myocardial function. Circulation 2000; 102: 1158–1164.Google Scholar
26. Galinier, M, Pathak, A, Roncalli, J, Massabuau, P. Obesity and cardiac failure. Arch Mal Coeur Vaiss 2005; 98: 39–45.Google Scholar
27. Langenberg, C, Sharp, SJ, et al. Long-termrisk of incident type 2 diabetes and measures of overall and regionalobesity: the EPIC-InterActcase-cohort study. PLoS Med 2012; 9: e1001230.Google Scholar
28. Singleton, JR, Smith, AG, Russell, JW, Feldman, EL. Microvascular complications of impaired glucose tolerance. Diabetes 2003; 52: 2867–2873.Google Scholar
29. Zibadi, S, Cordova, F, Slack, EH, Watson, RR, Larson, DF. Leptin’s regulation of obesity-induced cardiac extracellular matrix remodeling. Cardiovasc Toxicol 2011; 11: 325–333.CrossRefGoogle ScholarPubMed
30. Sharpe, JA, Naylor, LH, Jones, TW, et al. Impact of obesity on diastolic function in subjects <or=16 years of age. Am J Cardiol 2006; 98: 691–693.CrossRefGoogle ScholarPubMed
31. Gian, MF, Simone, DeG, Greco, R, Rosato, GF. Left ventricular filling pattern in uncomplicated obesity. Am J Cardiol 1996; 77: 509–514.Google Scholar
32. Erturk, L, Goksen, D, Ozyurek, AR, Darcan, S, Coker, M. Usefulness of the myocardial performance index (MPI) for assessing ventricular function in obese pediatric patients. Turk J Pediatr 2005; 47: 34–38.Google Scholar
33. Alpert, MA, Terry, BE, Kelly, DL. Effect of weight loss on cardiac chamber size, wall thickness and left ventricular function in morbid obesity. Am J Cardiol 1985; 55: 783–786.Google Scholar
34. Cetin, M, Caglayan, M, Yıldırımer, M, Kızılyıldız, BS, Deveci, M, Coskun, S. Tissue Doppler echocardiography for evaluating left ventricular functions in obese children. Dicle Med J 2013; 40: 9–14.Google Scholar
35. Juhola, J, Magnussen, CG, Viikari, JSA, et al. Tracking of serum lipid levels, blood pressure, and body mass index from childhood to adulthood: the cardiovascular risk in Young Finns study. J Pediatr 2011; 159: 584–590.Google Scholar
36. Morrison, JA, Glueck, CJ, Horn, PS, Yeramaneni, S, Wang, P. Pediatric triglycerides predict cardiovascular disease events in the fourth to fifth decade of life. Metabolism 2009; 58: 1277–1284.Google Scholar