Celik Ataç, Ozçetin Mustafa, Yerli Yasemin, Damar Ibrahim Halil, Kadı Hasan, Koç Fatih, Ceyhan Köksal
Department of Cardiology, Medicine Faculty of Gaziosmanpaşa University, Tokat, Turkey.
Turk Kardiyol Dern Ars. 2011 Oct;39(7):557-62. doi: 10.5543/tkda.2011.01694.
Obesity may start in childhood and obese children are more likely to grow up to be obese adults. Atherosclerosis is one of the most important complications of obesity. Pulse wave velocity (PWV), a noninvasive measure of arterial stiffness, is accepted to be an indicator of subclinical atherosclerosis. The aim of the study was to determine PWV in obese children.
The study included 30 obese (12 boys, 18 girls; mean age 13 ± 2 years) and 30 lean children (13 boys, 17 girls; mean age 12.5 ± 1.7 years). Weight and height were measured and obesity was defined as body mass index (BMI) of greater than the 95th percentile for age. All the subjects underwent echocardiographic evaluation and blood samples were obtained. Pulse-wave velocity was calculated using the following equation: PWV (m/sec) = height-based aortic length (cm)/(100xtransit time [sec]). The latter was measured as the difference in the time of onset of two flows at the diaphragm and the aortic valve.
Obese subjects had significantly higher blood pressure levels compared to the control group (p<0.001). The two groups were similar with respect to fasting glucose, hemoglobin, serum creatinine, and lipid levels. Among echocardiographic parameters, left ventricular end-diastolic dimension, interventricular septum thickness, posterior wall thickness, left ventricular mass index, left atrium dimension, and aortic root dimension were significantly increased in obese subjects compared to controls (p<0.01). Obese children had significantly higher PWV values than the controls (4.0 ± 0.8 vs. 3.3 ± 0.7 m/sec, p<0.001). A positive significant correlation was found between PWV and BMI (r=0.391, p=0.002).
Our findings show that aortic PWV is increased in obese children, suggesting that obesity may cause subclinical atherosclerosis even at early ages.
肥胖可能始于儿童期,肥胖儿童成年后更有可能成为肥胖者。动脉粥样硬化是肥胖最重要的并发症之一。脉搏波速度(PWV)是一种无创测量动脉僵硬度的方法,被认为是亚临床动脉粥样硬化的一个指标。本研究的目的是测定肥胖儿童的PWV。
该研究纳入了30名肥胖儿童(12名男孩,18名女孩;平均年龄13±2岁)和30名瘦儿童(13名男孩,17名女孩;平均年龄12.5±1.7岁)。测量体重和身高,肥胖定义为体重指数(BMI)高于年龄的第95百分位数。所有受试者均接受超声心动图评估并采集血样。脉搏波速度使用以下公式计算:PWV(米/秒)=基于身高的主动脉长度(厘米)/(100×传输时间[秒])。后者测量为膈肌和主动脉瓣处两个血流起始时间的差值。
与对照组相比,肥胖受试者的血压水平显著更高(p<0.001)。两组在空腹血糖、血红蛋白、血清肌酐和血脂水平方面相似。在超声心动图参数中,与对照组相比,肥胖受试者的左心室舒张末期内径、室间隔厚度、后壁厚度、左心室质量指数、左心房内径和主动脉根部内径显著增加(p<0.01)。肥胖儿童的PWV值显著高于对照组(4.0±0.8对3.3±0.7米/秒,p<0.001)。PWV与BMI之间存在显著正相关(r=0.391,p=0.002)。
我们的研究结果表明,肥胖儿童的主动脉PWV升高,提示肥胖即使在早期也可能导致亚临床动脉粥样硬化。