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肥胖儿童左心室重构与血脂谱的关联:一项观察性研究。

Association between left ventricular remodeling and lipid profiles in obese children: an observational study.

作者信息

Tang Ying, Yang Guang-Bin, Chen Jun, Chen Ye, Hua Li-Chun

机构信息

Department of Ultrasound, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.

Department of Ultrasound, The Fourth Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.

出版信息

Front Pediatr. 2024 Feb 23;12:1308887. doi: 10.3389/fped.2024.1308887. eCollection 2024.

Abstract

OBJECTIVE

Childhood obesity has become a prominent issue in the society, which can lead to left ventricular remodeling and severe cardiovascular complications in adulthood. It is beneficial to identify the causes of left ventricular remodeling so that targeted measures can be taken to prevent the cardiovascular disease. Therefore, this study aimed to explore the relationship between left ventricular remodeling and changes in blood lipid indexes in obese children.

METHODS

This study was conducted on 40 healthy non-obese children and 140 obese children diagnosed in the pediatric health department of our hospital. Clinical data collected from the two groups were compared. Echocardiography was performed to examine left ventricular configuration and cardiac function. Multiple linear regression analysis was conducted to assess the independent effects of blood lipid levels on echocardiographic parameters. Blood lipid indicators among different left ventricular structural patterns which were classified according to left ventricular mass indexes and relative wall thickness were compared.

RESULTS

Obese children exhibited significantly increased height, weight, body mass index (BMI), body fat percentage (BFP), blood pressure, triglycerides, total cholesterol, left ventricular internal diameter (LVIDd), interventricular septum (IVSd), left ventricular posterior wall diastolic thickness (LVPWd), myocardial mass (LVM) and relative wall thickness (RWT), as well as lower high-density lipoprotein cholesterol (HDL-C) and left ventricular ejection fraction (LVEF) compared to the non-obese children (< 0.05). Multiple linear correlation analysis showed LVM had a significantly positive correlation with BMI ( = 3.21,  = 0.002) and SBP ( = 2.61,  = 0.01); LVMI had a significantly negative correlation with HDL-C ( = -2.45,  = 0.015); RWT had a significantly positive correlation with SBP ( = 2.50,  = 0.013) but a significantly negative correlation with HDL-C ( = -2.35,  = 0.02). Furthermore, there were significant differences in HDL-C values among children with different ventricular configurations (< 0.05), with the lowest HDL-C value recorded in the concentric hypertrophy group.

CONCLUSION

Obese children will develop left ventricular remodeling. The left ventricular configuration indexes are most significantly associated with serum HDL-C. Lower HDL-C level contributes to severer left ventricular hypertrophy, indicating a concentric hypertrophy pattern.

摘要

目的

儿童肥胖已成为社会中的一个突出问题,它可导致左心室重构以及成年期严重的心血管并发症。确定左心室重构的原因有助于采取针对性措施预防心血管疾病。因此,本研究旨在探讨肥胖儿童左心室重构与血脂指标变化之间的关系。

方法

本研究对我院儿科保健科诊断的40名健康非肥胖儿童和140名肥胖儿童进行。比较两组收集的临床资料。进行超声心动图检查以评估左心室形态和心功能。进行多元线性回归分析以评估血脂水平对超声心动图参数的独立影响。比较根据左心室质量指数和相对壁厚度分类的不同左心室结构模式中的血脂指标。

结果

与非肥胖儿童相比,肥胖儿童的身高、体重、体重指数(BMI)、体脂百分比(BFP)、血压、甘油三酯、总胆固醇、左心室内径(LVIDd)、室间隔(IVSd)、左心室后壁舒张期厚度(LVPWd)、心肌质量(LVM)和相对壁厚度(RWT)显著增加,而高密度脂蛋白胆固醇(HDL-C)和左心室射血分数(LVEF)较低(<0.05)。多元线性相关分析显示,LVM与BMI(β = 3.21,P = 0.002)和收缩压(β = 2.61,P = 0.01)呈显著正相关;左心室质量指数(LVMI)与HDL-C呈显著负相关(β = -2.45,P = 0.015);RWT与收缩压呈显著正相关(β = 2.50,P = 0.013),但与HDL-C呈显著负相关(β = -2.35,P = 0.02)。此外,不同心室形态的儿童HDL-C值存在显著差异(<0.05),同心性肥厚组的HDL-C值最低。

结论

肥胖儿童会发生左心室重构。左心室形态指标与血清HDL-C最显著相关。较低的HDL-C水平会导致更严重的左心室肥厚,提示同心性肥厚模式。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d3b/10920330/9ea374a60a73/fped-12-1308887-g001.jpg

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