Impact of childhood obesity on cardiac structure and functions

Yıl 2017, Cilt: 8 Sayı: 1, 6 - 10, 31.03.2017

Fatih Atik Cihan Şanlı Ayça Törel Ergür Ayşegül Alpcan

https://doi.org/10.18663/tjcl.297946

Öz

Aim: The aim of this study was to compare the left
ventricle structure and its functions in obese children without established
complications and none obese children.

 

Material and Methods:
Anthropometric and conventional echocardiographic parameters of cardiac
geometry and left ventricular function were obtained in 40 obese children
without any other disease and complication of obesity like hypertension,
hypercholesterolemia, and a control group of 40 healthy lean. Fasting plasma
glucose, insulin levels were obtained and homeostatic model assessment of
insulin resistance (HOMA‐IR) were calculated.

 

Results: Height, weight, body surface area and body mass index
(BMI), were found significantly higher in the obese group (P < 0.001). Insulin
and HOMA‐IR scores were higher in obese
group. No significant differences were observed for left ventricular systolic
and diastolic diameter (P > 0.05). Left ventricular mass (LVM), LVM/ht,
LVM/BMI and relative wall thickness (RWT) were significantly increased in obese
children than the controls (P < 0.001) and most of them had eccentric left
ventricular (LV) hypertrophy. Ejection fraction was significantly decreased
seen obese group. A positive correlation was seen between BMI and LV posterior
wall thickness and interventricular septal thickness (R > 0.45, P < 0.05).
Both types of hypertrophy were seen in insulin resistant obese group.

 

Conclusion: The known causes are altered homeostatic and
neurohumoral mechanisms and compensation of higher metabolic demands and
increased left ventricular mass, reduced myocardial performance due to hemodynamic
load associated with higher cardiovascular morbidity and mortality rates.

Anahtar Kelimeler

Pediatric obesity, ventricular dysfunction, echocardiography

Çocukluk çağı obezitesinin kardiyak yapı ve fonksiyonlara etkisi

Öz

Amaç:
Bu çalışmada nonkomplike obez ve obez olmayan
çocuklarda sol ventrikül yapı ve fonksiyonların karşılaştırılması amaçlandı.

 

Gereç
ve Yöntemler: 40 sağlıklı obez olmayan ve obezitenin komplikasyonu
(hipertansiyon, hiperkolesterolemi vs) veya başka bir  hastalığı olmayan 40 obez çocukta kardiyak
geometrinin antropometik ve konvansiyonel ekokardiyografik parametreleri ve sol
ventrikül fonksiyonu elde edildi. Açlık plazma glukozu ve insülini bakılıp
insülin direnç parametresi (HOMA-IR) hesaplandı.

 

Bulgular:
Boy, ağırlık, vücut yüzey alanı, vücut kitle indeksi
obez grupta anlamlı olarak yüksek tespit edildi (P < 0,001). İnsülin ve
HOMA-IR obez grupta yüksekti. Sol ventrikül sistolik ve diyastolik çapları
arasında fark tespit edilmedi (P ˃ 0,05). Sol
ventrikül
kitlesi (LVM), LVM/ht, LVM/BMI, rölatif duvar
kalınlığı (RWT), obez çocuklarda kontrol grubuna göre oldukça artmıştı (P <
0,001) ve  bunların da en önemli olanı
ekzantrik sol ventrikül hipertrofisiydi. Ejeksiyon fraksiyon belirgin olarak
azalmıştı. BMI, LV posterior duvar kalınlığı ve interventriküler septal
kalınlık arasında belirgin korelasyon görüldü (R > 0,45, P < 0,05).
İnsülin rezistan obez grupta hipertrofinin her iki tipi de görüldü.

 

Sonuçlar: Değişen homeostatik ve nörohumoral mekanizmaların, yüksek  metabolik ihtiyacın kompansasyonunun artmış
sol ventrikül kitlesi, azalmış myokardiyal performans hemodinamik yük sebebi
olduğu, bunun da yüksek kardiyovasküler morbidite ve mortalite oranları ile
ilişkili olduğu biliniyor. Değişmiş homeostatik ve nörohumoral mekanizmalar,
artmış metabolik gereksinimler, artmış ventriküler kitle, azalmış myokardiyal
performans hemodinamik yol ile ilişkili olarak kardiyovasküler morbidite ve
mortalite oranlarını artırmaktadır.

Anahtar Kelimeler

Çocukluk çağı, venriküler disfonksiyon, ekokardiyografi

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