Department of Pediatrics, Clinic of University of Health Sciences, Ankara City Hospital, Ankara, Turkey.
Department of Pediatric Cardiology, Clinic of University of Health Sciences, Ankara City Hospital, Ankara, Turkey.
J Pediatr Endocrinol Metab. 2021 Apr 27;34(7):885-896. doi: 10.1515/jpem-2020-0597. Print 2021 Jul 27.
The objective of this study is to investigate the cardiovascular risk factors associated with metabolic syndrome (MetS), which is increasingly becoming prevalent in childhood obesity.
A total of 113 patients, 76 of whom were between the ages of 10 and 17 (mean age: 14.5 ± 1.8 years) and diagnosed with obesity (30 non-MetS and 46 MetS using IDF) and 37 of whom constituted the control group, participated in the study. Echocardiographic examination and atherogenicity parameters (Atherogenic index of plasma [AIP: logTG/HDL], total cholesterol/HDL, and TG/HDL ratio and non-HDL) were evaluated.
The most common component accompanying obese MetS was found to be hypertension and low HDL. While obesity duration, body mass index (BMI), blood pressure, fasting insulin, insulin resistance, atherogenicity parameters were determined to be significantly higher in the obese-MetS group. Echocardiography showed that while the thickness, volume, and diameter of LV end-diastolic wall, left ventricular mass (LVM), LVM index (LVMI g/m) and relative wall thickness (RWT) were significantly high in the MetS group, however, mitral E/A ratio was significantly lower (p<0.05). Change in LV geometry consistent with concentric remodeling (increased RWT, normal LVMI) was visible in obese groups. LVM were positively significantly related to BMI, waist circumference, insulin resistance, blood pressure, LDL level, and negative to mitral E/A ratio. In the obese-MetS group, LVMI was positively correlated to office systolic BP, left atrium end-diastolic volume/index.
LVMI and atherogenicity parameters that were found to be significantly higher in obese MetS exhibit increased cardiovascular risk in childhood.
本研究旨在探讨与代谢综合征（MetS）相关的心血管危险因素，MetS 在儿童肥胖中越来越普遍。
共有 113 名患者参与了这项研究，其中 76 名年龄在 10 至 17 岁之间（平均年龄：14.5±1.8 岁），被诊断为肥胖症（30 名非 MetS 和 46 名 MetS，使用 IDF 诊断），另外 37 名患者构成对照组。对超声心动图检查和动脉粥样硬化参数（血浆致动脉粥样硬化指数 [AIP：logTG/HDL]、总胆固醇/HDL、TG/HDL 比值和非-HDL）进行评估。
肥胖伴 MetS 最常见的伴随症状是高血压和低 HDL。肥胖持续时间、体重指数（BMI）、血压、空腹胰岛素、胰岛素抵抗、动脉粥样硬化参数在肥胖伴 MetS 组中显著更高。超声心动图显示，虽然 LV 舒张末期壁的厚度、容积和直径、左心室质量（LVM）、LVM 指数（LVMI g/m）和相对壁厚度（RWT）在 MetS 组中显著升高，但二尖瓣 E/A 比值显著降低（p<0.05）。在肥胖组中，可以看到与向心性重构一致的 LV 几何形状的变化（增加的 RWT、正常的 LVMI）。LVM 与 BMI、腰围、胰岛素抵抗、血压、LDL 水平呈正显著相关，与二尖瓣 E/A 比值呈负相关。在肥胖伴 MetS 组中，LVMI 与办公收缩压、左心房舒张末期容积/指数呈正相关。
在肥胖伴 MetS 中发现的 LVMI 和动脉粥样硬化参数显著升高，表明儿童时期心血管风险增加。
