Division of Pediatrics, Department of Health Sciences, University of Piemonte Orientale, Novara, Italy.
Vascular Surgery, Maggiore della Carità University Hospital, Novara, Italy.
Int J Cardiol. 2017 Dec 15;249:366-371. doi: 10.1016/j.ijcard.2017.09.031. Epub 2017 Sep 14.
Childhood obesity is associated with cardiovascular abnormalities but little is known on the potential correlation between early cardiovascular and metabolic alterations.
Aims of this study were 1) to evaluate early cardiovascular abnormalities in a large population of obese children and adolescents compared with a normal weight counterpart, 2) to investigate their potential association with insulin resistance (IR), serum uric acid (sUA) and metabolic syndrome (MetS).
This was a single-center case-control study. Eighty obese (OB) subjects (6-16years) and 20 normal weight (NW) matched controls were consecutively recruited. In the whole population we performed an anthropometric and a cardiovascular assessment. OB patients also underwent an OGTT and biochemical evaluations.
OB children showed greater left atrial (LA) and ventricular (LV) dimensions and mass and higher carotid artery intima-media thickness (CIMT), compared with NW controls. The BMI z-score, waist circumference, IR and sUA were positively related with LA and LV dimensions and mass. OB subjects with MetS (46.3%) showed greater LA diameter (p=0.001) and LV area (p=0.01) and volume (p=0.04) compared with OB children without MetS. LA diameter and LV dimensions and mass were significantly dependent on the number of criteria for MetS. Mets, sUA and IR were significant predictors of left heart dimensions and mass in obese children.
Obesity and MetS are associated with abnormal cardiovascular response during childhood. Hyperuricemia can be an early marker of cardiovascular dysfunction and the routine determination of circulating levels of sUA should be implemented during risk stratification among pediatric age.
儿童肥胖与心血管异常有关，但对于早期心血管和代谢变化之间的潜在相关性知之甚少。
本研究的目的是 1）评估肥胖儿童和青少年与正常体重对照组相比早期心血管异常，2）探讨其与胰岛素抵抗（IR）、血尿酸（sUA）和代谢综合征（MetS）的潜在相关性。
这是一项单中心病例对照研究。连续招募了 80 名肥胖（OB）患者（6-16 岁）和 20 名正常体重（NW）匹配对照者。在整个人群中，我们进行了一项体格检查和心血管评估。OB 患者还接受了 OGTT 和生化评估。
与 NW 对照组相比，OB 儿童的左心房（LA）和心室（LV）尺寸和质量更大，颈动脉内中膜厚度（CIMT）更高。BMI z 评分、腰围、IR 和 sUA 与 LA 和 LV 尺寸和质量呈正相关。患有 MetS（46.3%）的 OB 患者的 LA 直径（p=0.001）和 LV 面积（p=0.01）和体积（p=0.04）大于无 MetS 的 OB 儿童。LA 直径和 LV 尺寸和质量与 MetS 的标准数量显著相关。MetS、sUA 和 IR 是肥胖儿童左心尺寸和质量的显著预测因子。
肥胖和 MetS 与儿童期异常心血管反应有关。高尿酸血症可能是心血管功能障碍的早期标志物，应在儿科年龄进行风险分层时常规检测循环 sUA 水平。
