Abstract
BackgroundLeft ventricular hypertrophy (LVH) is an important risk factor for cardiovascular and all-cause mortality. Previous studies reported conflicting results concerning the relationship between serum lipid levels and left ventricular geometry pattern. We sought to explore the relationship between standard serum lipid profile measures with left ventricular geometry pattern in obese children.Patients and methodsIn this cross-sectional study, a total of 70 obese children were examined. Fasting blood samples were taken to measure total cholesterol, low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), triglycerides (TGs), glucose, and insulin. Based on these values TG/HDL ratio, BMI and HOMA index were calculated. We also measured the average 24-h ambulatory systolic blood pressure (SBP) and two-dimensional (2/D) transthoracic echocardiography was performed to determine left ventricular mass index (LVMI) and relative wall thickness (RWT). Multiple regression analyses were conducted to explore relationships between study variables and the LVMI or RWT as outcome variables. The final model with LVMI included TG/HDL ratio, BMI, 24 h-average SBP, age and sex, while for the RWT we included BMI, insulin, age and sex.ResultsOur study included 70 children (65.71% boys and 34.29% girls) median age (14 years, IQR = 12–16)." We demonstrated independent and positive association of TG/HDL ratio, BMI and 24 h-average SBP with LVMI (effect = 3.65, SE = 1.32, p < 0.01; effect = 34.90, SE = 6.84, p < 0.01; effect = 0.32, SE = 0.12, p < 0.01, respectively). On the other hand, in model with RWT as outcome variable, only BMI and insulin were significantly linked (BMI: effect = 13.07, SE = 5.02, p = 0.01 Insulin: effect = 2.80, SE = 0.97).ConclusionIncreased TG/HDL ratio in obese children is associated with the development of eccentric left ventricular hypertrophy while increased BMI and insulin were associated with concentric left ventricular hypertophy.
Highlights
It is well established that the left ventricular hypertrophy (LVH) is an important risk factor for cardiovascular and all-cause mortality and morbidity [1,2,3]
On the other hand, altered lipid profile including elevated triglycerides (TG), VLDL (Very-Low-Density Lipoprotein) total cholesterol (TC) and low High-Density Lipoprotein (HDL) cholesterol is a frequent metabolic abnormality possible contributing to the development of cardiac hypertrophy in obese children [16, 17]
It was shown that VLDL can promote aldosterone overproduction which in turn may induce LV remodeling independently of its hemodynamic effects on systemic BP [14, 18] In addition, the results of several cross-sectional and longitudinal studies reported that increased plasma aldosterone is associated with decreased high density lipoprotein cholesterol (HDL-C) and increased triglycerides in patients with metabolic syndrome [19]
Summary
It is well established that the left ventricular hypertrophy (LVH) is an important risk factor for cardiovascular and all-cause mortality and morbidity [1,2,3]. On the other hand, altered lipid profile including elevated triglycerides (TG), VLDL (Very-Low-Density Lipoprotein) total cholesterol (TC) and low High-Density Lipoprotein (HDL) cholesterol is a frequent metabolic abnormality possible contributing to the development of cardiac hypertrophy in obese children [16, 17]. Left ventricular hypertrophy (LVH) is an important risk factor for cardiovascular and all-cause mortality. Previous studies reported conflicting results concerning the relationship between serum lipid levels and left ventricular geometry pattern. We sought to explore the relationship between standard serum lipid profile measures with left ventricular geometry pattern in obese children
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