Institute of Cardiovascular and Medical Sciences, BHF Glasgow Cardiovascular Research Centre, 126 University Place, University of Glasgow, Glasgow G12 8TA, UK.
Diabetologia. 2011 Apr;54(4):715-8. doi: 10.1007/s00125-010-2041-0. Epub 2011 Jan 19.
Obesity in young people is an emerging public health problem, particularly because of its association with type 2 diabetes. Since obesity and diabetes contribute to the development of cardiovascular disease in adults, the question arises as to whether or not these conditions may be associated with cardiovascular abnormalities in children and adolescents. In this issue of Diabetologia, Shah et al. report the results of a cross-sectional study of heart structure and function in 612 adolescents and young adults (aged 10-24 years) subdivided into three groups: (1) those with obesity and type 2 diabetes; (2) those with type 2 diabetes but without obesity; and (3) lean healthy controls. Their results revealed that left ventricular mass (indexed to body surface area) was greater in the obese individuals than in lean controls. Left ventricular systolic function was more dynamic in obese participants and obese participants with type 2 diabetes compared with lean controls, whereas systolic function was comparable in obese patients with or without type 2 diabetes. Furthermore, compared with the healthy lean control participants, diastolic function was impaired in the obese group and further impaired in the obese individuals with diabetes. These results, and those of a few other similar studies, lend support to the notion that obesity and diabetes in children cause subtle abnormalities in cardiovascular structure and function. The present commentary discusses potential mechanisms and possible clinical ramifications for such findings.
年轻人肥胖是一个新出现的公共卫生问题，特别是因为它与 2 型糖尿病有关。由于肥胖和糖尿病会导致成年人心血管疾病的发生，因此人们不禁要问，这些情况是否与儿童和青少年的心血管异常有关。在本期《糖尿病学》杂志上，Shah 等人报告了对 612 名青少年和年轻人（年龄 10-24 岁）心脏结构和功能的横断面研究结果，这些人被分为三组：（1）肥胖且患有 2 型糖尿病的人；（2）患有 2 型糖尿病但不肥胖的人；（3）瘦的健康对照组。他们的研究结果显示，肥胖者的左心室质量（按体表面积校正）大于瘦对照组。与瘦对照组相比，肥胖者的左心室收缩功能更具活力，肥胖合并 2 型糖尿病者的左心室收缩功能也如此，而肥胖伴或不伴 2 型糖尿病者的收缩功能相当。此外，与健康瘦对照组相比，肥胖组的舒张功能受损，而肥胖合并糖尿病者的舒张功能进一步受损。这些结果以及其他一些类似研究的结果支持这样一种观点，即儿童肥胖和糖尿病会导致心血管结构和功能的细微异常。本评论讨论了这些发现的潜在机制和可能的临床意义。
