Karaağaç Aysu Türkmen, Yıldırım Ayşe İnci
Department of Pediatry, University of Health Sciences, Kartal Koşuyolu Research and Training Hospital, Istanbul, Turkey.
Department of Pediatric Cardiology, University of Health Sciences, Kartal Koşuyolu Research and Training Hospital, Istanbul, Turkey.
Cardiol Young. 2019 Feb;29(2):200-205. doi: 10.1017/S1047951118002093. Epub 2019 Feb 1.
Obesity is a global health issue in both children and adults. Besides its comorbidities, cardiac structure and functions may be impaired from childhood if obesity is not controlled in the growing years. The effects of diet and exercise on the cardiovascular functions and biochemical parameters of obese children were evaluated in this study.In a tertiary hospital, 6-16-year-old of mean age 10.8±2.3 years, non-random voluntarily selected 34 obese children with body mass index above 95th percentile and no syndromic or systemic illnesses were enrolled in this prospective study. Weights, heights, and blood pressures were recorded. Cardiac functions were evaluated by M-mode and tissue Doppler echocardiography. Glucose, HbA1c, cholesterol, triglyceride, liver enzyme, and thyroid hormone levels were analysed. These measurements were repeated after a 6-month diet and exercise programme. The results were compared statistically.Echocardiography of the obese children after diet and exercise showed significantly increased ejection fraction, fractional shortening, mitral annular plane systolic excursion and mitral systolic velocity values, associated with the systolic ventricular functions, and decreased tissue Doppler mitral and tricuspid early diastolic velocities, related with the early diastolic ventricular functions, compared with before diet and exercise (p<0.05). Moreover, the body mass index, glucose, cholesterol, and triglyceride levels significantly decreased after diet and exercise (p<0.05).The systolic and early diastolic cardiac functions are impaired and the biochemical parameters are distorted starting from the childhood because of the obesity. Regular diet and exercise provide significant improvement. Cardiac evaluation should be routinely performed in all obese children and they should be encouraged for a regular diet and exercise for better cardiovascular health.
肥胖是儿童和成人共同面临的全球性健康问题。除了其合并症外,如果在成长过程中肥胖得不到控制,心脏结构和功能可能从儿童时期就受到损害。本研究评估了饮食和运动对肥胖儿童心血管功能和生化参数的影响。
在一家三级医院,非随机自愿选取了34名年龄在6至16岁、平均年龄为10.8±2.3岁、体重指数高于第95百分位且无综合征或全身性疾病的肥胖儿童参与这项前瞻性研究。记录了体重、身高和血压。通过M型和组织多普勒超声心动图评估心脏功能。分析了血糖、糖化血红蛋白、胆固醇、甘油三酯、肝酶和甲状腺激素水平。在进行为期6个月的饮食和运动计划后,重复进行这些测量。对结果进行统计学比较。
与饮食和运动前相比,肥胖儿童在饮食和运动后的超声心动图显示,与心室收缩功能相关的射血分数、缩短分数、二尖瓣环平面收缩期位移和二尖瓣收缩期速度值显著增加,与心室舒张早期功能相关的组织多普勒二尖瓣和三尖瓣舒张早期速度降低(p<0.05)。此外,饮食和运动后体重指数、血糖、胆固醇和甘油三酯水平显著降低(p<0.05)。
由于肥胖,从儿童时期开始,心脏的收缩和舒张早期功能就受到损害,生化参数也发生扭曲。规律的饮食和运动能带来显著改善。应常规对所有肥胖儿童进行心脏评估,并鼓励他们保持规律饮食和运动,以促进更好的心血管健康。