Abstract
BackgroundChildren with congenital heart disease (CHD) have an elevated risk of future cardiovascular disease but the underlying mechanisms are unclear. Abdominal obesity (measured as waist circumference) is a risk factor for adult onset of cardiovascular diseases and is correlated with low physical activity levels, commonly found in children with congenital heart disease. Elevated waist circumference may be a mechanism by which cardiovascular disease risk is elevated in children with CHD. The purpose of this study was to compare waist circumference between children with and without CHD, while considering potential confounders. We hypothesized that children with CHD would have higher measures of waist circumference when controlling for differences in birthweight, lean mass, and physical activity.MethodsThirty-two children with CHD (10.9 ± 2.6 years; 12 female) from the Children’s Healthy-Heart Activity Monitoring Program in Saskatchewan, and 23 healthy controls (11.7 ± 2.5 years; 10 female) were studied. Waist circumference, physical activity (physical activity questionnaire), body composition (lean mass; dual x-ray absorptiometry), and birthweight were assessed. Analysis of covariance, Mann-Whitney U, and independent sample t-tests were used to assess group differences (p < 0.05).ResultsChildren with CHD had greater waist circumference than controls, controlling for lean mass, physical activity, birthweight, and sex (F (1, 49) = 4.488, p = 0.039). Physical activity, lean mass, and birthweight were not significantly different between groups (p > 0.05).ConclusionOur findings generate a novel hypothesis—higher waist circumferences in children with CHD compared to age-matched controls, may contribute to an elevated risk of cardiovascular disease.
Highlights
Children with congenital heart disease (CHD) have an elevated risk of future cardiovascular disease but the underlying mechanisms are unclear
CHD and control groups were similar in age, birthweight, height, weight, body mass index (BMI), total fat mass, total lean mass, percent fat mass, percent lean mass, and physical activity score (p > 0.05)
There was no significant association between physical activity quartile and CHD/control group (x2 (3) = 5.036, p = 0.169) or between waist circumference quartile and CHD/control group (x2 (3) = 0.990, p = 0.804); there was a 26 cm difference in waist circumference identified between the top (56.8 ± 3.1 cm) and bottom quartile (83.2 ± 13.9 cm) of physical activity when groups were combined (p < 0.001)
Summary
Children with congenital heart disease (CHD) have an elevated risk of future cardiovascular disease but the underlying mechanisms are unclear. Abdominal obesity (measured as waist circumference) is a risk factor for adult onset of cardiovascular diseases and is correlated with low physical activity levels, commonly found in children with congenital heart disease. A surrogate measure of abdominal fat deposition, may be a contributing factor in the process linking CHD to adult cardiovascular disease. Waist circumference has been linked to low birthweight, catch-up growth, and low physical activity; further, there are longitudinal relationships between birthweight, early childhood growth, and childhood abdominal fat and adult cardiovascular health [7, 9, 10, 19,20,21]. Elevated waist circumference during childhood may pose a similar cardiovascular disease risk to children with CHD as it does in other populations, but to date this has not been properly explored
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