Subclinical myocardial dysfunction and cardiac autonomic dysregulation are closely associated in obese children and adolescents: the potential role of insulin resistance.
Subclinical myocardial dysfunction and cardiac autonomic dysregulation are closely associated in obese children and adolescents: the potential role of insulin resistance.
复制标题
DOI：
10.1371/journal.pone.0123916
复制
发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Miraglia Del Giudice E
中科院分区：
文献类型：
--
作者：
Cozzolino D;Grandone A;Cittadini A;Palmiero G;Esposito G;De Bellis A;Furlan R;Perrotta S;Perrone L;Torella D;Miraglia Del Giudice E
儿童/青少年中肥胖症的流行率正在上升。据报道，肥胖儿童/青少年中存在轻微的心血管异常，导致日后死亡率较高。本研究的目的是评价心血管自主调节，通过频谱分析的R-R间期变异性，心肌功能，通过标准和组织多普勒超声心动图，在一组非高血压的无症状肥胖儿童和青少年;此外，胰岛素抵抗的影响进行了测试。在70 °头高位倾斜和24小时心电图霍尔特监测期间分析R-R间期变异性。R-R间期变异性的频谱分析提供了窦房结交感神经（低频[LFRR]）和迷走神经（高频[HFRR]）调制的指标。使用胰岛素抵抗稳态模型评估（HOMA-IR）将肥胖儿童/青少年（n = 72）分为胰岛素抵抗（n = 37）和非胰岛素抵抗（n = 35）。肥胖受试者：a）左心室质量显著B）静息时HFRR较低，LFRR/HFRR较高，倾斜时HFRR抑制程度较低，24小时动态霍尔特心电图监测时LFRR和LFRR/HFRR较高，HFRR较低; e）HOMA-IR与e '/a '比率（r =-0.655; p <0.001）和倾斜诱导的LFRR/HFRR比率（r =-0.933; p <0.001）两者呈负相关;和f）e '/a'比率与倾斜诱导的LFRR/HFRR比率相关（r = 0.501; p <0.001）。此外，与其他受试者相比，胰岛素抵抗性肥胖儿童/青少年的静息HFRR、倾斜诱导的HFRR降低幅度和e "/a "比值明显较低。肥胖儿童/青少年心肌功能和心脏自主调节的亚临床异常与胰岛素抵抗程度密切相关。
The prevalence of obesity is increasing among children/adolescents. Subtle cardiovascular abnormalities, responsible for a higher mortality later in life, have been reported in obese children/adolescents. The aims of the study were to evaluate cardiovascular autonomic regulation, by means of spectrum analysis of R-R interval variability, and myocardial function, by means of standard and tissue Doppler echocardiography, in a group of non-hypertensive asymptomatic obese children and adolescents; furthermore, the influence of insulin resistance was tested. R-R interval variability was analyzed during both the 70° head-up tilt and 24-hour electrocardiographic holter monitoring. Spectrum analysis of R-R interval variability provided the indices of sympathetic (low frequency [LFRR]) and vagal (high frequency [HFRR]) modulation of the sinoatrial node. Homeostasis model assessment of insulin resistance (HOMA-IR) was used to classify obese children/adolescents (n=72) as insulin resistant (n=37) and non-insulin resistant (n=35). In obese subjects: a) left ventricular mass was significantly (p<0.05) increased, whereas both the e/a ratio and the e'/a' ratio were decreased; b) at rest, HFRR was lower, and the LFRR/HFRR ratio was higher; c) during tilting, magnitude of tilt-induced inhibition of HFRR was lower; d) during 24-hour electrocardiographic holter monitoring, LFRR and the LFRR/HFRR ratio were higher, whereas HFRR was lower; e) HOMA-IR inversely correlated with both the e'/a' ratio (r=-0.655; p<0.001) and the tilt-induced LFRR/HFRR ratio (r=-0.933; p<0.001); and, f) the e'/a' ratio correlated with the tilt-induced LFRR/HFRR ratio (r=0.501; p<0.001). Moreover, HFRR at rest, magnitude of tilt-induced HFRR reduction, and the e'/a' ratio in insulin resistant obese children/adolescents were markedly lower when compared with the remaining subjects. Subclinical abnormalities of myocardial function and of cardiac autonomic regulation were closely associated in obese children/adolescents and both correlated with the degree of insulin resistance.
登录
查看更多内容
影响因子：
39.3
作者：
SCAGLIONE, R;DICHIARA, MA;LICATA, G
通讯作者：
LICATA, G
影响因子：
37.8
作者：
Furlan, R;Porta, A;Mosqueda-Garcia, R
通讯作者：
Mosqueda-Garcia, R
影响因子：
39.3
作者：
Di Salvo, Giovanni;Pacileo, Giuseppe;Calabro, Raffaele
通讯作者：
Calabro, Raffaele
影响因子：
--
作者：
POMERANZ, B;MACAULAY, RJB;BENSON, H
通讯作者：
BENSON, H
影响因子：
9.8
作者：
Reinehr, T;Kiess, W;Wunsch, R
通讯作者：
Wunsch, R