Impact of childhood obesity on cardiac structure and functions

Öz

Aim: The aim of this study was to compare the left ventricle structure and its functions in obese children without established complications and none obese children.

 

Material and Methods: Anthropometric and conventional echocardiographic parameters of cardiac geometry and left ventricular function were obtained in 40 obese children without any other disease and complication of obesity like hypertension, hypercholesterolemia, and a control group of 40 healthy lean. Fasting plasma glucose, insulin levels were obtained and homeostatic model assessment of insulin resistance (HOMA‐IR) were calculated.

 

Results: Height, weight, body surface area and body mass index (BMI), were found significantly higher in the obese group (P < 0.001). Insulin and HOMA‐IR scores were higher in obese group. No significant differences were observed for left ventricular systolic and diastolic diameter (P > 0.05). Left ventricular mass (LVM), LVM/ht, LVM/BMI and relative wall thickness (RWT) were significantly increased in obese children than the controls (P < 0.001) and most of them had eccentric left ventricular (LV) hypertrophy. Ejection fraction was significantly decreased seen obese group. A positive correlation was seen between BMI and LV posterior wall thickness and interventricular septal thickness (R > 0.45, P < 0.05). Both types of hypertrophy were seen in insulin resistant obese group.

 

Conclusion: The known causes are altered homeostatic and neurohumoral mechanisms and compensation of higher metabolic demands and increased left ventricular mass, reduced myocardial performance due to hemodynamic load associated with higher cardiovascular morbidity and mortality rates.

Anahtar Kelimeler

• Pediatric obesity,ventricular dysfunction,echocardiography

Çocukluk çağı obezitesinin kardiyak yapı ve fonksiyonlara etkisi

Öz

Amaç: Bu çalışmada nonkomplike obez ve obez olmayan çocuklarda sol ventrikül yapı ve fonksiyonların karşılaştırılması amaçlandı.

 

Gereç ve Yöntemler: 40 sağlıklı obez olmayan ve obezitenin komplikasyonu (hipertansiyon, hiperkolesterolemi vs) veya başka bir  hastalığı olmayan 40 obez çocukta kardiyak geometrinin antropometik ve konvansiyonel ekokardiyografik parametreleri ve sol ventrikül fonksiyonu elde edildi. Açlık plazma glukozu ve insülini bakılıp insülin direnç parametresi (HOMA-IR) hesaplandı.

 

Bulgular: Boy, ağırlık, vücut yüzey alanı, vücut kitle indeksi obez grupta anlamlı olarak yüksek tespit edildi (P < 0,001). İnsülin ve HOMA-IR obez grupta yüksekti. Sol ventrikül sistolik ve diyastolik çapları arasında fark tespit edilmedi (P ˃ 0,05). Sol ventrikül kitlesi (LVM), LVM/ht, LVM/BMI, rölatif duvar kalınlığı (RWT), obez çocuklarda kontrol grubuna göre oldukça artmıştı (P < 0,001) ve  bunların da en önemli olanı ekzantrik sol ventrikül hipertrofisiydi. Ejeksiyon fraksiyon belirgin olarak azalmıştı. BMI, LV posterior duvar kalınlığı ve interventriküler septal kalınlık arasında belirgin korelasyon görüldü (R > 0,45, P < 0,05). İnsülin rezistan obez grupta hipertrofinin her iki tipi de görüldü.

 

Sonuçlar: Değişen homeostatik ve nörohumoral mekanizmaların, yüksek  metabolik ihtiyacın kompansasyonunun artmış sol ventrikül kitlesi, azalmış myokardiyal performans hemodinamik yük sebebi olduğu, bunun da yüksek kardiyovasküler morbidite ve mortalite oranları ile ilişkili olduğu biliniyor. Değişmiş homeostatik ve nörohumoral mekanizmalar, artmış metabolik gereksinimler, artmış ventriküler kitle, azalmış myokardiyal performans hemodinamik yol ile ilişkili olarak kardiyovasküler morbidite ve mortalite oranlarını artırmaktadır.

Anahtar Kelimeler

• Çocukluk çağı,venriküler disfonksiyon,ekokardiyografi

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