肥胖儿童的血脂谱和左心室几何形态。
Lipid profile and left ventricular geometry pattern in obese children.
机构信息
Clinical Center, Nis, Zorana Djindjica 48 Boulevard, Nis, 18000, Serbia.
Medical faculty, University of Nis, Nis, Serbia.
出版信息
Lipids Health Dis. 2020 May 26;19(1):109. doi: 10.1186/s12944-020-01285-9.
BACKGROUND
Left ventricular hypertrophy (LVH) is an important risk factor for cardiovascular and all-cause mortality. Previous studies reported conflicting results concerning the relationship between serum lipid levels and left ventricular geometry pattern. We sought to explore the relationship between standard serum lipid profile measures with left ventricular geometry pattern in obese children.
PATIENTS AND METHODS
In this cross-sectional study, a total of 70 obese children were examined. Fasting blood samples were taken to measure total cholesterol, low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), triglycerides (TGs), glucose, and insulin. Based on these values TG/HDL ratio, BMI and HOMA index were calculated. We also measured the average 24-h ambulatory systolic blood pressure (SBP) and two-dimensional (2/D) transthoracic echocardiography was performed to determine left ventricular mass index (LVMI) and relative wall thickness (RWT). Multiple regression analyses were conducted to explore relationships between study variables and the LVMI or RWT as outcome variables. The final model with LVMI included TG/HDL ratio, BMI, 24 h-average SBP, age and sex, while for the RWT we included BMI, insulin, age and sex.
RESULTS
Our study included 70 children (65.71% boys and 34.29% girls) median age (14 years, IQR = 12-16)." We demonstrated independent and positive association of TG/HDL ratio, BMI and 24 h-average SBP with LVMI (effect = 3.65, SE = 1.32, p < 0.01; effect = 34.90, SE = 6.84, p < 0.01; effect = 0.32, SE = 0.12, p < 0.01, respectively). On the other hand, in model with RWT as outcome variable, only BMI and insulin were significantly linked (BMI: effect = 13.07, SE = 5.02, p = 0.01 Insulin: effect = 2.80, SE = 0.97).
CONCLUSION
Increased TG/HDL ratio in obese children is associated with the development of eccentric left ventricular hypertrophy while increased BMI and insulin were associated with concentric left ventricular hypertophy.
背景
左心室肥厚（LVH）是心血管和全因死亡率的重要危险因素。先前的研究报告了血清脂质水平与左心室几何形态之间的关系存在矛盾的结果。我们试图探讨肥胖儿童中标准血清脂质谱与左心室几何形态之间的关系。
患者和方法
在这项横断面研究中，共检查了 70 名肥胖儿童。抽取空腹血样测量总胆固醇、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、甘油三酯（TGs）、葡萄糖和胰岛素。根据这些值计算 TG/HDL 比值、BMI 和 HOMA 指数。我们还测量了平均 24 小时动态收缩压（SBP），并进行二维（2/D）经胸超声心动图检查以确定左心室质量指数（LVMI）和相对壁厚度（RWT）。进行多元回归分析以探讨研究变量与作为因变量的 LVMI 或 RWT 之间的关系。最终的 LVMI 模型包括 TG/HDL 比值、BMI、24 小时平均 SBP、年龄和性别，而 RWT 模型包括 BMI、胰岛素、年龄和性别。
结果
我们的研究包括 70 名儿童（65.71%为男孩，34.29%为女孩），中位年龄为 14 岁（IQR=12-16 岁）。我们证明了 TG/HDL 比值、BMI 和 24 小时平均 SBP 与 LVMI 呈独立且正相关（效应=3.65，SE=1.32，p<0.01；效应=34.90，SE=6.84，p<0.01；效应=0.32，SE=0.12，p<0.01，分别）。另一方面，在 RWT 作为因变量的模型中，只有 BMI 和胰岛素与 RWT 显著相关（BMI：效应=13.07，SE=5.02，p=0.01；胰岛素：效应=2.80，SE=0.97）。
结论
肥胖儿童中 TG/HDL 比值的增加与偏心性左心室肥厚的发展有关，而 BMI 和胰岛素的增加与向心性左心室肥厚有关。
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