Giannisi Filippina, Keivanidou Anastasia, Sakellari Ioanna, Balala Sofia, Hassapidou Maria, Hitoglou-Makedou Areti, Giannopoulos Andreas
2nd Pediatric Department, Aristotle University of Thessaloniki, AHEPA General Hospital, 54636 Thessaloniki, Greece.
Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece.
Diagnostics (Basel). 2020 Jul 10;10(7):468. doi: 10.3390/diagnostics10070468.
Εmerging data indicate that various effects of obesity on the cardiovascular system can be evident during childhood. The aim of this study was to detect early changes in left ventricular structure and function in obese normotensive children and explore possible associations of these changes with anthropometric and biochemical parameters. Normotensive 8-11-year-old obese and normal weight children were included in the study. They all underwent anthropometric measurements, laboratory tests, and echocardiography study by conventional and tissue Doppler to assess geometric pattern and function of left ventricle. Statistically significant differences in most anthropometric and metabolic parameters were noticed between groups. Obese children showed higher left ventricular mass index (LVMI) (40.05 ± 9.44 vs. 28.31 ± 6.22), lower E/A ratio (1.76 ± 0.33 vs. 2.08 ± 0.56), and higher E/e' (6.04 ± 1.13 vs. 5.43 ± 0.96) compared to lean peers. Waist-to-height ratio and hs-CRP correlated significantly with E/A in the obese group. Left ventricular hypertrophy was present in 47.2% of obese children and eccentric was the prominent type. Waist-to-height ratio and serum cortisol levels in plasma increased the odds of having any type of abnormal ventricular geometric pattern. Echocardiographic evaluation of left ventricle and diastolic function could be considered for obese normotensive children based on waist-to-height ratio, hs-CRP, and serum cortisol.
新出现的数据表明，肥胖对心血管系统的各种影响在儿童期可能就很明显。本研究的目的是检测肥胖血压正常儿童左心室结构和功能的早期变化，并探讨这些变化与人体测量学和生化参数之间可能存在的关联。研究纳入了8至11岁血压正常的肥胖儿童和正常体重儿童。他们均接受了人体测量、实验室检查以及通过传统和组织多普勒超声心动图研究，以评估左心室的几何形态和功能。两组之间在大多数人体测量和代谢参数上存在统计学显著差异。与瘦的同龄人相比，肥胖儿童的左心室质量指数（LVMI）更高（40.05±9.44 vs. 28.31±6.22），E/A比值更低（1.76±0.33 vs. 2.08±0.56），E/e'更高（6.04±1.13 vs. 5.43±0.96）。在肥胖组中，腰高比和超敏C反应蛋白（hs-CRP）与E/A显著相关。47.2%的肥胖儿童存在左心室肥厚，且以离心性肥厚为主要类型。腰高比和血浆中的血清皮质醇水平增加了出现任何类型异常心室几何形态的几率。对于肥胖血压正常的儿童，可根据腰高比、hs-CRP和血清皮质醇考虑对左心室和舒张功能进行超声心动图评估。
