Influence of obesity and insulin resistance on left atrial size in children
Influence of obesity and insulin resistance on left atrial size in children
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DOI：
10.1111/j.1399-543x.2006.00139.x
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发表时间：
2006-02-01
影响因子：
3.4
通讯作者：
Jadzinsky, M
中科院分区：
文献类型：
--
作者：
Hirschler, V;Acebo, HLP;Jadzinsky, M
左心房（LA）扩大已与肥胖和胰岛素抵抗的adults.Objective：本研究的目的是确定在儿童之间的关联LA面积和：（i）代谢综合征的不同组成部分，包括肥胖（OB）、体重指数（BMI）和腰围（WC）的测量、稳态模型评估-胰岛素抵抗（ii）左心室质量（LVM）和舒张功能，使用回波多普勒测量。方法和结果：84名（44名女性）受试者，[40名OB（BMI > 95%），28名超重（BMI > 85%）]，16名非OB（BMI < 85%）]，年龄9 ± 12.24岁，性别和年龄匹配。BMI、WC、BP、坦纳分级和M型。2-二维和多普勒超声心动图进行了评估。进行标准口服葡萄糖耐量试验（OGTT），测量葡萄糖、胰岛素和胰岛素原浓度。高血压仅存在于OB受试者中（25%）。显著单变量关联LA面积与身高之间存在差异（p < 0.001）（r = 0.52），年龄（r = 0.45），坦纳级（r = 0.45）、BMI（r = 0.66）、WC（r = 0.70）、收缩压（r = 0.52）、舒张压（r = 0.53）、胰岛素原（r = 0.36）和HOMA-IR（r = 0.36）。在多变量回归分析中，以逐步方式输入自变量：最初，性别（p = 0.006）和坦纳分期（p = 0.011）在调整年龄、性别和坦纳分期后仍然是LA面积的显著独立相关因素。随后，结合WC显示WC（p = 0.018）是LA面积的显著独立相关性。一个更大的模型构建来测试的调整因素，包括WC，BP，左心室质量，和HOMA-IR的显着性显示，WC（p < 0.001）是唯一显着的独立variable.Conclusion：LA扩大是目前在儿童和腹部OB和胰岛素抵抗，这表明，中央OB儿童心血管疾病的风险增加。
Left atrial (LA) enlargement has been linked to obesity and insulin resistance in adults.Objective: The purpose of this study was to determine the association in children between LA area and: (i) different components of the metabolic syndrome including obesity (OB), measures of body mass index (BMI) and waist circumference (WC), homeostasis model assessment-insulin resistance (HOMA-IR, proinsulin), and blood pressure (BP); and (ii) left ventricular mass (LVM) and diastolic function, measured using echo Doppler.Methods and results: Eighty-four (44 females) subjects, [40 OB (BMI > 95%), 28 overweight (BMI > 85%)], 16 non-OB (BMI < 85%)] aged 9 +/- 12.24 yrs were matched for sex and age. BMI, WC, BP, Tanner stage, and Mode M.. 2-dimensional and Doppler transmitral echocardiography were assessed. A standard oral glucose tolerance test (OGTT) was done, measuring glucose, insulin, and proinsulin concentrations. Hypertension was only present in OB subjects (25%). Significant univariate association (p < 0.001) was found between LA area and height (r = 0.52), age (r = 0.45), Tanner stage (r = 0.45), BMI (r = 0.66) WC (r = 0.70), systolic BP (r = 0.52), diastolic BP (r = 0.53), proinsulin (r = 0.36), and HOMA-IR (r = 0.36). In the multivariate regression analysis, independent variables were entered in a stepwise fashion: initially, gender (p = 0.006) and Tanner stage (p = 0.011) were still significant independent correlates of LA area after adjusting for age, gender, and Tanner stage. Subsequently, incorporation of WC showed that WC (p = 0.018) was a significant independent correlate of LA area. A larger model constructed to test the significance of adjustment factors, including WC, BP, LVM, and HOMA-IR showed that WC (p < 0.001) was the only significant independent variable.Conclusion: LA enlargement is present in childhood and is related to abdominal OB and insulin resistance, suggesting that children with central OB are at increased risk for cardiovascular disease.