Hostname: page-component-586b7cd67f-rdxmf Total loading time: 0 Render date: 2024-11-30T19:01:27.292Z Has data issue: false hasContentIssue false
  • English
  • Français

Insulin resistance surrogates and left ventricular hypertrophy in normotensive obese children

Part of: Echocardiography Metabolic

Published online by Cambridge University Press:  22 March 2021

Ljiljana Bjelakovic ,
Vladimir Vukovic Open the ORCID record for Vladimir Vukovic [Opens in a new window] ,
Sanja Stankovic Open the ORCID record for Sanja Stankovic [Opens in a new window] ,
Milan Ciric ,
Stevo Lukic ,
Milovan Bratic ,
Sasa Pantelic ,
Ljiljana Saranac  and
Bojko Bjelakovic Open the ORCID record for Bojko Bjelakovic [Opens in a new window]
Ljiljana Bjelakovic
Affiliation:
Department of medical science, Faculty of Sport and Physical Education, University of Nis, Nis, Serbia
Vladimir Vukovic
Affiliation:
Centre for Disease Control and Prevention, Institute of Public Health of Vojvodina, Novi Sad, Serbia
Sanja Stankovic
Affiliation:
Center for Medical Biochemistry, University Clinical Center of Serbia, Belgrade, Serbia
Milan Ciric
Affiliation:
Medical Faculty, University of Nis, Nis, Serbia
Stevo Lukic
Affiliation:
Clinic of Neurology, Clinical Center, Nis, Serbia, Medical Faculty, University of Nis, Nis, Serbia
Milovan Bratic
Affiliation:
Department of medical science, Faculty of Sport and Physical Education, University of Nis, Nis, Serbia
Sasa Pantelic
Affiliation:
Department of medical science, Faculty of Sport and Physical Education, University of Nis, Nis, Serbia
Ljiljana Saranac
Affiliation:
Clinic of Pediatrics, Clinical Center, Nis, Serbia, Medical Faculty, University of Nis, Nis, Serbia
Bojko Bjelakovic*
Affiliation:
Clinic of Pediatrics, Clinical Center, Nis, Serbia, Medical Faculty, University of Nis, Nis, Serbia
*
Author for correspondence: Bojko Bjelakovic MD, Ph.D. Associate Prof., Clinic of Pediatrics, Clinical Center, Nis, Zorana Djindjica 48 Boulevard, 18000 Nis, Serbia. Tel: +381652083321; Fax: +381184234190. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

The relationship between different surrogates of insulin resistance and left ventricular geometry in obese children is still unclear.

Objective:

We sought to explore the relationship between commonly used measures of insulin sensitivity/resistance (homeostatic model assessment index, serum uric acid, and triglycerides to high-density lipoprotein cholesterol ratio) and left ventricular geometry in normotensive obese children.

Methods:

In this cross-sectional study, 32 normotensive obese children were examined. Transthoracic echocardiography was used to measure left ventricular mass index and relative wall thickness. Homeostasis model assessment index, serum uric acid level, and a ratio of triglycerides to high-density lipoprotein cholesterol were used as markers of the insulin resistance. Simple and partial correlation analyses (to control for the effects of body mass index) were conducted to explore relationship between studied variables and left ventricular mass index or relative wall thickness as outcome variables.

Results:

We found positive correlations between homeostasis model assessment index and relative wall thickness (r = 0.47, p = 0.03) which remained significant after controlling for the effect of body mass index, z-score (r = 0.48, p = 0.03). The cutoff level of homeostasis model assessment index with the optimum sensitivity (Sn) and specificity (Sp) derived from the receiver operating characteristic (ROC) curves for predicting concentric remodelling was ≥5.51 with Sn = 83.33 and Sp = 68.75.

Conclusion:

There is a positive relationship between homeostasis model assessment index and relative wall thickness of obese normotensive children which may help to distinguish at risk obese normotensive children for the development of concentric left ventricular remodelling.

Keywords

Obesityinsulin resistancechildrenleft ventricular mass indexrelative wall thickness
Type
Original Article
Information
Cardiology in the Young , Volume 31 , Issue 12 , December 2021 , pp. 1901 - 1906
Check for updates
Copyright
© The Author(s), 2021. Published by Cambridge University Press

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

Ormazabal, V, Nair, S, Elfeky, O, Aguayo, C, Salomon, C, Zuñiga, FA. Association between insulin resistance and the development of cardiovascular disease. Cardiovasc Diabetol 2018; 17: 122.CrossRefGoogle ScholarPubMed
Gutin, B, Treiber, F, Owens, S, Mensah, GA. Relations of body composition to left ventricular geometry and function in children. J Pediatr 1998; 132: 1023–1027.CrossRefGoogle ScholarPubMed
Steinberger, J, Jacobs, DR, Moran, A, et al. Relation of insulin resistance and body composition to left ventricular mass in children. Am J Cardiol 2002; 90: 1177–1180.CrossRefGoogle Scholar
Urbina, EM, Gidding, SS, Bao, W, Elkasabany, A, Berenson, GS. Association of fasting blood sugar level, insulin level, and obesity with left ventricular mass in healthy children and adolescents: the Bogalusa heart study. Am Heart J 1999; 138: 122–127.CrossRefGoogle ScholarPubMed
Samuelsson, AM, Bollano, E, Mobini, R, et al. Hyperinsulinemia: Effect on cardiac mass/function, angiotensin II receptor expression, and insulin signaling pathways. Am J Physiol – Heart Circ Physiol 2006; 291: H787–H796.CrossRefGoogle ScholarPubMed
Pires, A, Martins, P, Pereira, AM, et al. Insulin resistance, dyslipidemia and cardiovascular changes in a group of obese children. Arq Bras Cardiol 2015; 104: 266–273.Google Scholar
Klisic, A, Kavaric, N, Ninic, A. Serum cystatin C levels are associated with triglycerides/high-density lipoprotein cholesterol ratio in adolescent girls ages between 16–19 years old. Eur Rev Med Pharmacol Sci 2020; 24: 10680–10686.Google ScholarPubMed
Bjelakovic, B, Stefanutti, C, Bonic, D, et al. Serum uric acid and left ventricular geometry pattern in obese children. Atheroscler Suppl 2019; 40: 88–93.CrossRefGoogle ScholarPubMed
Bjelakovic, B, Stefanutti, C, Vukovic, V, et al. Lipid profile and left ventricular geometry pattern in obese children. Lipids Health Dis 2020; 26: 109.CrossRefGoogle Scholar
Kuczmarski, RJ, Ogden, CL, Grummer-Strawn, LM, et al. CDC growth charts: United States. Adv Data 2000; 314: 1–27.Google Scholar
Wallace, TM, Levy, JC, Matthews, DR. Use and abuse of HOMA modeling. Diabetes Care 2004; 27: 1487–1495.CrossRefGoogle Scholar
Weiss, R, Otvos, JD, Sinnreich, R, Miserez, AR, Kark, JD. The triglyceride to high-density lipoprotein-cholesterol ratio in adolescence and subsequent weight gain predict nuclear magnetic resonance-measured lipoprotein subclasses in adulthood. J Pediatr 2011; 158: 44–50.CrossRefGoogle ScholarPubMed
Dawson, J, Wyss, A. Chicken or the Egg? Hyperuricemia, insulin resistance, and hypertension. Hypertension 2017; 70: 698–699.CrossRefGoogle ScholarPubMed
Cheng, TH, Lin, JW, Chao, HH, et al. Uric acid activates extracellular signal-regulated kinases and thereafter endothelin-1 expression in rat cardiac fibroblasts. Int J Cardiol 2010; 139: 42–49.CrossRefGoogle ScholarPubMed
Hsu, Y-H, Chen, J-J, Chang, N-C, et al. Role of reactive oxygen species-sensitive extracellular signal-regulated kinase pathway in angiotensin II-induced endothelin-1 gene expression in vascular endothelial cells. J Vasc Res 2004; 41: 64–74.CrossRefGoogle ScholarPubMed
Richey, Pa, Disessa, TG, Somes, GW, Alpert, BS, Jones, DP. Left ventricular geometry in children and adolescents with primary hypertension. Am J Hypertens 2010; 23: 24–29.CrossRefGoogle ScholarPubMed
Yan, Y, Liu, J, Wang, L, et al. Independent influences of excessive body weight and elevated blood pressure from childhood on left ventricular geometric remodeling in adulthood. Int J Cardiol 2017; 243: 492–496.CrossRefGoogle ScholarPubMed
DeBosch, BJ, Muslin, AJ. Insulin signaling pathways and cardiac growth. J Moll Cell Cardiol 2008; 44: 855–864.CrossRefGoogle ScholarPubMed
Bjelakovic, B. Cardiovascular risk prediction in children with focus on obesity. Prev Ped 2015; 1: 24–28.Google Scholar
Laustsen, PG, Russell, SJ, Cui, L, et al. Essential role of insulin and insulin-like growth factor 1 receptor signaling in cardiac development and function. Mol Cell Biol 2007; 27: 1649–1664.CrossRefGoogle ScholarPubMed
Saranac, LJ, Gucev, Z. Ghrelin system. Beyond the role in energy homeostasis. Facta Universitatis 2016; 18: 33–38.Google Scholar
Sundström, J, Lind, L, Vessby, B, Andrén, B, Aro, A, Lithell, H. Dyslipidemia and an unfavorable fatty acid profile predict left ventricular hypertrophy 20 years later. Circulation 2001; 103: 836–841.CrossRefGoogle Scholar
Levelt, E, Mahmod, M, Piechnik, SK, et al. Relationship between left ventricular structural and metabolic remodelling in type 2 diabetes mellitus. Diabetes 2015; 65: 44–52.CrossRefGoogle Scholar
Mishra, S, Bedja, D, Amuzie, C, Avolio, A, Chatterjee, S. Prevention of cardiac hypertrophy by the use of a glycosphingolipid synthesis inhibitor in ApoE-/- mice. Biochem Biophys Res Commun 2015; 465: 159–164.CrossRefGoogle Scholar
Ferrara, AL, Vaccaro, O, Cardoni, O, Panarelli, W, Laurenzi, M, Zanchetti, A. Is there a relationship between left ventricular mass and plasma glucose and lipids independent of body mass index? Results of the Gubbio study. Nutr Metab Cardiovasc Dis 2003; 13: 126–132.CrossRefGoogle Scholar
Kishi, S, Gidding, SS, Reis, JP, et al. Association of insulin resistance and glycemic metabolic abnormalities with LV structure and function in middle age: the CARDIA study. JACC Cardiovasc Imaging 2017; 10: 105–114.CrossRefGoogle ScholarPubMed
Vaccaro, O, Cardoni, O, Cuomo, V, et al. Relationship between plasma insulin and left ventricular mass in normotensive participants of the Gubbio study. Clin Endocrinol (Oxf) 2003; 58: 316–322.CrossRefGoogle ScholarPubMed
Atabek, ME, Akyüz, E, Eklioǧlu, BS, Çimen, D. The relationship between metabolic syndrome and left ventricular mass index in obese children. J Clin Res Pediatr Endocrinol 2011; 3: 132–138.CrossRefGoogle ScholarPubMed
Yoneyama, K, Venkatesh, BA, Wu, CO, et al. Diabetes mellitus and insulin resistance associate with left ventricular shape and torsion by cardiovascular magnetic resonance imaging in asymptomatic individuals from the multi-ethnic study of atherosclerosis. J Cardiovasc Magn Reson 2018; 30: 53.CrossRefGoogle Scholar