Abstract
Εmerging data indicate that various effects of obesity on the cardiovascular system can be evident during childhood. The aim of this study was to detect early changes in left ventricular structure and function in obese normotensive children and explore possible associations of these changes with anthropometric and biochemical parameters. Normotensive 8–11-year-old obese and normal weight children were included in the study. They all underwent anthropometric measurements, laboratory tests, and echocardiography study by conventional and tissue Doppler to assess geometric pattern and function of left ventricle. Statistically significant differences in most anthropometric and metabolic parameters were noticed between groups. Obese children showed higher left ventricular mass index (LVMI) (40.05 ± 9.44 vs. 28.31 ± 6.22), lower E/A ratio (1.76 ± 0.33 vs. 2.08 ± 0.56), and higher E/e’ (6.04 ± 1.13 vs. 5.43 ± 0.96) compared to lean peers. Waist-to-height ratio and hs-CRP correlated significantly with E/A in the obese group. Left ventricular hypertrophy was present in 47.2% of obese children and eccentric was the prominent type. Waist-to-height ratio and serum cortisol levels in plasma increased the odds of having any type of abnormal ventricular geometric pattern. Echocardiographic evaluation of left ventricle and diastolic function could be considered for obese normotensive children based on waist-to-height ratio, hs-CRP, and serum cortisol.
Highlights
Childhood obesity, defined as abnormal or excessive fat accumulation that presents a risk to health, is one of the most challenging health problems around the world, with increasing rates in developed and in developing countries during the last decades [1]
Statistically significant differences were revealed in all anthropometric parameters and biochemical markers except for total cholesterol, HbA1c and cortisol levels
By means of binary logistic regression in obese children, the estimated odds ratio for the presence of any type of abnormal geometry increased for every one unit increase of Waist-to-height ratio (WHtR) (OR: 1.296, 95% CI:1.046–1.605), p: 0.018) and log serum cortisol
Summary
Childhood obesity, defined as abnormal or excessive fat accumulation that presents a risk to health, is one of the most challenging health problems around the world, with increasing rates in developed and in developing countries during the last decades [1]. It is estimated that 40 million children under the age of 5 years and more than 330 million children and adolescents aged 5–19 years were overweight or obese in 2016 [2] It seems that a high percentage of obese children tend to remain obese through adolescence and adulthood [3] with higher cardiovascular risk [4]. Overweight or obesity in adolescence may account for as much as 20% of cardiovascular deaths and 25% of deaths from coronary heart disease in midlife [5] Incidence of comorbidities such as hypertension, insulin resistance, type 2 diabetes, non-alcoholic liver disease, and dyslipidemia seems to be higher in obese teens compared to normal weight peers [6].
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