Pires António, Martins Paula, Pereira Ana Margarida, Silva Patricia Vaz, Marinho Joana, Marques Margarida, Castela Eduardo, Sena Cristina, Seiça Raquel
Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
Instituto Biomédico de Investigação da Luz e Imagem, Faculdade de Medicina, Universidade de Coimbra, Coimbra, Portugal.
Arq Bras Cardiol. 2015 Apr;104(4):266-73. doi: 10.5935/abc.20140206. Epub 2015 Jan 23.
Obesity-related comorbidities are present in young obese children, providing a platform for early adult cardiovascular disorders.
To compare and correlate markers of adiposity to metabolic disturbances, vascular and cardiac morphology in a European pediatric obese cohort.
We carried out an observational and transversal analysis in a cohort consisting of 121 obese children of both sexes, between the ages of 6 and 17 years. The control group consisted of 40 children with normal body mass index within the same age range. Markers of adiposity, plasma lipids and lipoproteins, homeostasis model assessment-insulin resistance, common carotid artery intima-media thickness and left ventricular diameters were analyzed.
There were statistically significant differences between the control and obese groups for the variables analyzed, all higher in the obese group, except for age, high-density lipoprotein cholesterol and adiponectin, higher in the control group. In the obese group, body mass index was directly correlated to left ventricular mass (r=0.542; p=0.001), the homeostasis model assessment-insulin resistance (r=0.378; p=<0.001) and mean common carotid artery intima-media thickness (r=0.378; p=<0.001). In that same group, insulin resistance was present in 38.1%, 12.5% had a combined dyslipidemic pattern, and eccentric hypertrophy was the most common left ventricular geometric pattern.
These results suggest that these markers may be used in clinical practice to stratify cardiovascular risk, as well as to assess the impact of weight control programs.
肥胖相关的合并症在肥胖的儿童中就已出现，这为成年早期心血管疾病提供了一个发病基础。
在一个欧洲儿科肥胖队列中，比较肥胖指标与代谢紊乱、血管和心脏形态之间的关系，并进行相关性分析。
我们对一个队列进行了观察性横断面分析，该队列由121名6至17岁的肥胖儿童组成，男女均有。对照组由40名年龄范围相同、体重指数正常的儿童组成。分析了肥胖指标、血浆脂质和脂蛋白、稳态模型评估-胰岛素抵抗、颈总动脉内膜中层厚度和左心室直径。
分析的变量在对照组和肥胖组之间存在统计学显著差异，除年龄、高密度脂蛋白胆固醇和脂联素（对照组较高）外，肥胖组的所有变量均较高。在肥胖组中，体重指数与左心室质量直接相关（r = 0.542；p = 0.001）、稳态模型评估-胰岛素抵抗（r = 0.378；p < 0.001）和平均颈总动脉内膜中层厚度（r = 0.378；p < 0.001）。在同一组中，38.1%存在胰岛素抵抗，12.5%有合并血脂异常模式，偏心性肥厚是最常见的左心室几何模式。
这些结果表明，这些指标可用于临床实践中对心血管风险进行分层，以及评估体重控制计划的效果。
