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肥胖儿童和青少年早期超声心动图异常以及显著减重后这些异常的可逆性。

Early echocardiography abnormalities in obese children and adolescent and reversibility of these abnormalities after significant weight reduction.

作者信息

Ghanem Sabry, Mostafa Mansour, Ayad Sherif

机构信息

Department of Pediatrics, Alazhar University, Cairo, Egypt.

出版信息

J Saudi Heart Assoc. 2010 Jan;22(1):13-8. doi: 10.1016/j.jsha.2010.03.003. Epub 2010 Mar 10.

Abstract

BACKGROUND

Obesity is becoming an epidemic threat for the individual and society. The increasing prevalence of overweight children and adolescents is likely to have a great impact on the future cardiovascular health of these subjects. Obesity is a strong risk factor for cardiovascular morbidity and mortality. Cardiac abnormalities of obese children and adolescents include the echocardiographically revealed early and preclinical LV or septal hypertrophy, and left or right ventricular dysfunction. Most of these abnormalities, which are usually more pronounced in patients with morbid obesity, can be partially reversed after weight reduction.

AIM OF THE STUDY

Evaluate early echocardiography changes in obese children and whether these cardiac abnormalities reverse with significant weight reduction in children and adolescents or not.

METHODS

We started this study by 50 obese children and adolescents and 30 non obese controls matched for age and sex. BMI was calculated. Complete echocardiographic study was performed on each patient and control subject. Hematological and biochemical variables were determined in the obese subjects from fasting blood samples and included glucose, total cholesterol, triglycerides (TG), HDL cholesterol and LDL cholesterol. All our patients' strict dietetic regime with exercises for 6 months. After 6 months full examination, including all measurements and echocardiography and laboratory investigations were done again.

RESULTS

Obese children has abnormalities of left ventricle structure and function (consisting of increased left ventricular wall dimensions and mass and alteration of diastolic function) that can be detected by echocardiography. Furthermore, (parameters of lipid metabolism) were found to be independent predictors of adverse LV remodeling and of diastolic dysfunction. As well as this study provides evidence that abnormalities of left ventricular wall dimension and mass in obese children and adolescents can improve with significant weight reduction.

CONCLUSION

This study has demonstrated that young, obese children and adolescents have early significant changes in left ventricular wall dimensions and early diastolic filling compared with non obese and this changes are reversible with weight reduction.

摘要

背景

肥胖正成为对个人和社会的一种流行性威胁。超重儿童和青少年患病率的上升可能会对这些人群未来的心血管健康产生重大影响。肥胖是心血管发病和死亡的一个强有力的危险因素。肥胖儿童和青少年的心脏异常包括超声心动图显示的早期和临床前左心室或室间隔肥厚,以及左心室或右心室功能障碍。这些异常大多在病态肥胖患者中更为明显,体重减轻后可部分逆转。

研究目的

评估肥胖儿童早期超声心动图变化,以及这些心脏异常在儿童和青少年体重显著减轻后是否会逆转。

方法

我们招募了50名肥胖儿童和青少年以及30名年龄和性别相匹配的非肥胖对照者开始这项研究。计算体重指数(BMI)。对每位患者和对照者进行完整的超声心动图检查。从肥胖受试者的空腹血样中测定血液学和生化变量,包括血糖、总胆固醇、甘油三酯(TG)、高密度脂蛋白胆固醇和低密度脂蛋白胆固醇。所有患者严格节食并进行6个月的运动。6个月后进行全面检查,包括再次进行所有测量、超声心动图检查和实验室检查。

结果

肥胖儿童存在左心室结构和功能异常(包括左心室壁尺寸和质量增加以及舒张功能改变),可通过超声心动图检测到。此外,(脂质代谢参数)被发现是左心室不良重塑和舒张功能障碍的独立预测因素。而且这项研究提供了证据表明肥胖儿童和青少年左心室壁尺寸和质量的异常在体重显著减轻后可以改善。

结论

本研究表明,与非肥胖儿童相比,肥胖的儿童和青少年左心室壁尺寸和早期舒张期充盈有早期显著变化,且这些变化可通过体重减轻而逆转。

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