Alkholy Usama M, Ahmed Ihab A, Karam Nehad A, Ali Yasser Fathy, Yosry Ahmed
Department of Pediatrics, Zagazig University, Zagazig, aEgypt.
Department of Cardiology, Zagazig University, Zagazig, bEgypt.
J Saudi Heart Assoc. 2016 Jul;28(3):159-66. doi: 10.1016/j.jsha.2015.06.002. Epub 2015 Jul 2.
Childhood obesity is a major risk factor for cardiovascular diseases in children and adults.
The purpose of this study was to evaluate the serum leptin level and the cardiac changes in normotensive obese children and to study the relationship between left ventricular mass index (LVMI) and serum leptin with the parameters of metabolic syndrome (MS) in obese children.
This study was conducted in al Jeddani Hospital and Ibn Sina College Hospital in Saudi Arabia in the period from July 2012 to December 2013, and included 82 obese children. Their mean age was 10.2 ± 2.8 years; they were divided into 25 obese children with MS and 57 obese children without MS, and 40 healthy age- and sex-matched children were also included in the study as a control group. All children were subjected to clinical assessment including standing height, body weight, body mass index (BMI), waist circumference (WC), and blood pressure measurements. All children received an echocardiographic examination (2-dimensional, M-mode, Doppler, and tissue Doppler echocardiograpy) and laboratory assessment of serum leptin level, fasting glucose, fasting insulin, the homeostatic model assessment for insulin resistance (HOMA) index, total cholesterol, triglycerides, and high- and low-density lipoprotein profile.
BMI, BMI standard deviation score, WC, fasting glucose, fasting insulin, HOMA index and the serum leptin level were significantly higher in obese children compared to control group (p < 0.05). The LVMI were increased in the obese compared to the control group (p < 0.001) while left ventricle systolic and diastolic functions did not differ in obese versus control group (p > 0.05). There was a significant positive correlation between both LVMI and serum leptin level in comparison to BMI, WC, fasting glucose, fasting insulin, HOMA, triglycerides, and low-density lipoprotein in all obese children, especially the MS group. However, there was a significant negative correlation between both LVMI and serum leptin level in comparison to high-density lipoprotein.
Assessment of LVMI as routine echocardiographic examinations and serum leptin level might be a feasible and reliable method for the evaluation of obesity and its related cardiovascular risks during childhood that can predict metabolic syndrome and insulin resistance.
儿童肥胖是儿童及成人患心血管疾病的主要风险因素。
本研究旨在评估血压正常的肥胖儿童的血清瘦素水平及心脏变化，并研究肥胖儿童左心室质量指数（LVMI）和血清瘦素与代谢综合征（MS）参数之间的关系。
本研究于2012年7月至2013年12月在沙特阿拉伯的杰达尼医院和伊本·西那学院医院进行，纳入了82名肥胖儿童。他们的平均年龄为10.2±2.8岁；分为25名患有MS的肥胖儿童和57名未患MS的肥胖儿童，另外还纳入40名年龄和性别匹配的健康儿童作为对照组。所有儿童均接受临床评估，包括测量身高、体重、体重指数（BMI）、腰围（WC）和血压。所有儿童均接受超声心动图检查（二维、M型、多普勒和组织多普勒超声心动图）以及血清瘦素水平、空腹血糖、空腹胰岛素、胰岛素抵抗稳态模型评估（HOMA）指数、总胆固醇、甘油三酯以及高密度和低密度脂蛋白水平的实验室评估。
与对照组相比，肥胖儿童的BMI、BMI标准差评分、WC、空腹血糖、空腹胰岛素、HOMA指数和血清瘦素水平显著更高（p<0.05）。与对照组相比，肥胖儿童的LVMI升高（p<(0.001)），而肥胖组与对照组的左心室收缩和舒张功能无差异（p>0.05）。在所有肥胖儿童中，尤其是MS组，与BMI、WC、空腹血糖、空腹胰岛素、HOMA、甘油三酯和低密度脂蛋白相比，LVMI和血清瘦素水平之间存在显著正相关。然而，与高密度脂蛋白相比，LVMI和血清瘦素水平之间存在显著负相关。
将LVMI评估作为常规超声心动图检查以及检测血清瘦素水平，可能是评估儿童期肥胖及其相关心血管风险的一种可行且可靠的方法，可预测代谢综合征和胰岛素抵抗。
