Influence Of Childhood Obesity Research Articles

Does obesity have an effect on the ECG in children?

This review summarizes current data on influences of childhood obesity on the 12-lead electrocardiogram (ECG). Studies on obese adults showed a higher risk of cardiovascular complications and also, partly pathological, ECG alterations. Data on ECG alterations in obese children is rare. In current studies, no pathological findings were found. All alterations, which mimic the later pathological phenomena in obese adults, were within normal ranges. Studies reported significantly longer P-wave time and P-wave dispersion (Pd) in obese children [Üner A, Doğan M, Epcacan Z, Epçaçan S. The effect of childhood obesity on cardiac functions. J Pediatr Endocr Met 2014;27:261-71.], no correlation of heart rate, P-wave, or QT dispersions (QTd) [Akyüz A, Alpsoy S, Akkoyun DC, Nalbantoǧlu B, Tülübaș F, et al. Effect of overweight on P-wave and QT dispersions in childhood. Turk Kardiyol Dern Ars 2013;41:515-21.], significantly higher QTd in obese children [Yildirim S, Binnetoglu FK, Battal F, Aylanc H, Nazan Kaymaz N, et al. Relation between QT variables and left ventricular geometry in athletes and obese children. Acta Med Port 2016;29:95-100.], no significant association between obesity and QTc interval (QTc), but longer PR intervals, wider QRS duration and left axis shifting of frontal P-wave, QRS and T-wave axes [Sun G, Li Y, Zho X, Guuo X, Zhang X, et al. Association between obesity and ECG variables in children and adolescents: a cross-sectional study. Exp Ther Med 2013;6:1455-62.], significant prolongation of QTc, T peak-to-end, and QTd in the obese children [Paech C, Liebold A, Gebauer RA, Wagner F, Vogel M, et al. Relative QT interval prolongation and electrical inhomogeneity of cardiac repolarization in childhood obesity. Prog Pediatr Cardiol 2017;47:64-7.], slight shift to the left in the QRS axis (with no changes in the P axis), increased amplitudes of the left-sided leads in obese children, and no correlation of the heart rate with the weight [Paech C, Anhalt M, Gebauer RA, Wagner F, Vogel M, et al. New normal limits for pediatric ECG in childhood obesity? Influence of childhood obesity on the ECG. Prog Pediatr Cardiol 2018;48:119-23.]. Altogether, the study results are inconsistent. Clearly, pathological phenomena in the ECG of obese children were not reported: only preliminary stages like QTc prolongation within the norm were found. The pathological alterations seen in adult obese patients are not (yet) seen in childhood. The slight changes reported in childhood obesity are likely to manifest later and to develop into pathological phenomena in obese adults and, therefore, might increase the risk of cardiovascular events like arrhythmia and sudden cardiac death in adulthood.

Associations Between Obesity and Pediatric Foot Dimensions.

The influence of childhood obesity on shape and structure of the pediatric foot remains poorly understood. The purpose of this work was to determine associations between obesity and pediatric foot dimensions. A retrospective analysis of pediatric foot dimensions (foot length [FL] and foot width [FW]) in 3,713 children aged 3 to 18 years was undertaken. Logistic regression was used to determine relationships between FL, FW, and weight category. Compared with obese peers, typical weight (FL, P < .05 [odds ratio (OR)] = .83; FW, P < .05 [OR = .56]) and underweight (FL, P < .05 [OR = .76]; FW, P < .05 [OR = .41]) boys had significantly shorter and narrower feet. Overweight (FL, P = .02 [OR = .88]; FW, P = .02 [OR = .72]), typical weight (FL, P < .05 [OR = .77]; FW, P < .05 [OR = .47]), and underweight (FL, P < .05 [OR = .70]; FW, P < .05 [OR = .33]) girls had significantly shorter and narrower feet. These findings suggest that obesity is an important determinant of pediatric foot dimensions. Given the current prevalence of obesity in children and young people, these findings may have population-wide implications for pediatric foot health.

Influence of Obesity on Association Between Genetic Variants Identified by Genome-Wide Association Studies and Hypertension Risk in Chinese Children

Childhood hypertension is a complex disease influenced by both genetic and environmental factors. We aimed to examine how obesity status influences the association of 6 single nucleotide polymorphisms (SNPs) identified by genome-wide association studies (GWASs) with systolic/diastolic blood pressure (SBP/DBP) and hypertension in Chinese children. We recruited 619 hypertensive case subjects and 2,458 individuals with normal blood pressure from the Beijing Child and Adolescent Metabolic Syndrome study, a population-based case-control study. We selected 6 SNPs from earlier GWASs of hypertension and genotyped them using TaqMan assay. In the normal weight group, we did not observe any significant association of 6 SNPs and the genetic risk score (GRS) with SBP/DBP and hypertension (all P > 0.05). Only STK39 rs3754777 was significantly associated with higher DBP (P = 0.02) in the overweight subjects. In the obese group, 3 SNPs and the GRS were significantly associated with higher SBP (ATP2B1 rs17249754: P = 0.02; CSK rs1378942: P = 0.003; CYP17A1 rs1004467: P = 0.04; GRS: P = 0.0002). We also observed a significant association of 4 SNPs and the GRS with hypertension (ATP2B1 rs17249754: P = 0.02; CSK rs1378942: P = 0.02; CYP17A1 rs1004467: P = 0.02; MTHFR rs1801133: P = 0.03; GRS: P = 0.0004). Correction for multiple testing had no influence on the statistical significance of the association of GRS with SBP/hypertension. This study shows a significant association of hypertension susceptibility loci only in obese Chinese children, suggesting a likely influence of childhood obesity on the risk of hypertension.