Anthropometric and Biochemical Markers as Possible Indicators of Left Ventricular Abnormal Geometric Pattern and Function Impairment in Obese Normotensive Children

Giannisi, Filippina; Keivanidou, Anastasia; Sakellari, Ioanna; Balala, Sofia; Hassapidou, Maria; Hitoglou-Makedou, Areti; Giannopoulos, Andreas A.

doi:10.3390/diagnostics10070468

Cited by 5 publications

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References 67 publications

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“…Both obese children and CKD patients are at risk of developing LVH, which is confirmed by data from clinical trials. In obese children without hypertension, LVH was found in 47.2% and correlated with WHtR ( 17 ). In a large group of children from the Chronic Kidney Disease in Children study, higher BMI also significantly increased the risk of LVH ( 18 ).…”

Section: Discussionmentioning

confidence: 99%

Metabolic syndrome as risk factor for left ventricular hypertrophy in children with chronic kidney disease

et al. 2023

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BackgroundThe metabolic syndrome (MS), a cluster of clinical and biochemical abnormalities including insulin resistance, dyslipidemia and hypertension, is often diagnosed in chronic kidney disease (CKD) children. Left ventricular hypertrophy (LVH) is a major target organ damage in hypertension and an important cardiovascular risk factor in CKD patients. We aimed to identify the most significant risk factors of LVH in children with CKD.MethodsChildren with CKD stage 1-5 were enrolled in the study. MS was diagnosed according to De Ferranti (DF) as ≥3 from 5 criteria. Ambulatory blood pressure measurements (ABPM) and echocardiographic evaluation were performed. LVH was defined as ≥95th percentile of LV mass index related to height and age. Clinical and laboratory parameters included: serum albumin, Ca, HCT, cystatin C, creatinine, estimated glomerular filtration rate (eGFR) based on Schwartz formula, triglycerides, high-density lipoprotein (HDL), proteinuria, BMI standard deviation score (SDS), height SDS, waist circumference, ABPM data.Results71 children (28 girls/43 boys) with median age 14.05 (25%-75%:10.03-16.30) years and median eGFR 66.75 (32.76-92.32) ml/min/1.73m2 were evaluated. CKD stage 5 was diagnosed in 11 pts (15.5%). MS (DF) was diagnosed in 20 pts (28.2%). Glucose ≥ 110 mg/dL was present in 3 pts (4.2%); waist circumference ≥75th pc in 16 pts (22.5%); triglycerides ≥ 100 mg/dL in 35 pts (49.3%); HDL < 50mg/dL in 31 pts (43.7%) and BP ≥ 90th pc in 29 pts (40.8%), respectively. LVH was detected in 21 (29.6%) children. In univariate regression the strongest risk factor for LVH was CKD stage 5 (OR 4.9, p=0.0019) and low height SDS (OR 0.43,p=0.0009). In stepwise multiple logistic regression analysis (logit model) of the most important risk factors for LVH in CKD children, only three were statistically significant predictors: 1)MS diagnosis based on DF criteria (OR=24.11; 95%CI 1.1-528.7; p=0.043; Chi2 = 8.38,p=0.0038); 2), high mean arterial pressure (MAP SDS) in ABPM (OR=2.812; 95%CI 1.057-7.48; p=0.038;Chi2 = 5.91, p=0.015) and 3) low height SDS (OR=0.078; 95%CI 0.013-0.486;p=0.006; Chi2 = 25.01, p<0.001).ConclusionsIn children with chronic kidney disease LVH is associated with the cluster of multiple factors, among them the components of MS, hypertension, stage 5 CKD and growth deficit were the most significant.

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Section: Discussionmentioning

confidence: 99%

Metabolic syndrome as risk factor for left ventricular hypertrophy in children with chronic kidney disease

et al. 2023

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“…In our study, obesity was also associated with LVG remodeling, and the magnitude of the association of obesity with CH was the strongest, followed by EH and CR. A study including 62 normotensive children aged 8-11 years showed that elevated WHtR increased the odds of any phenotype of LVG remodeling ( 8 ). A study among 526 children aged 6-15 years found that neither obesity (defined by BMI) nor WC Z-score was associated with CR, whereas obesity and WC Z-score was independently associated with EH and CH ( 11 ).…”

Section: Discussionmentioning

confidence: 99%

“…Importantly, participants converting from CR to normal geometry had decreased risk of all-cause mortality (16). LVH has been the most common target organ damage in children and adolescents with hypertension (17), and obesity is strongly associated with abnormal LVG modeling (8)(9)(10)(11). Therefore, assessing the presence of LVH and LVG in the early life using a simple and effective obesity-related indicator could be helpful to prevent target organ damage such as LVG remodeling in the short term and the CVD outcomes in the long term.…”

Section: Introductionmentioning

confidence: 99%

“…Obesity is related to cardiovascular (CV) risk (including hyperglycemia, elevated blood pressure, dyslipidemia, metabolic syndrome, and insulin resistance) ( 5 ) and short-term target organ damage ( 6 , 7 ) in childhood. For example, obesity increases the risk of left ventricular hypertrophy (LVH) and left ventricular geometric (LVG) remodeling ( 8 – 11 ) (markers of cardiac structural damage), which are independent predictors of cardiovascular disease (CVD) ( 12 , 13 ).…”

Section: Introductionmentioning

confidence: 99%

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Utility of Three Adiposity Indices for Identifying Left Ventricular Hypertrophy and Geometric Remodeling in Chinese Children

et al. 2021

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BackgroundPrevious studies have shown that waist-to-height ratio (WHtR) performed similarly well when compared to body mass index (BMI) and waist circumference (WC) for identifying cardiovascular risk factors. However, to our knowledge, the performance of these three adiposity indices for identifying left ventricular hypertrophy (LVH) and left ventricular geometric (LVG) remodeling in youth has not been assessed. We aimed to determine the utility of BMI, WC and WHtR for identifying LVH and LVG in Chinese children.MethodsThis study included 1,492 Chinese children aged 6-11 years. Adiposity indices assessed were BMI, WC and WHtR. LVH and high relative wall thickness (RWT) were defined using sex- and age-specific 90th percentile values of left ventricular mass index and RWT, respectively, based on the current population. LVG remodeling included concentric remodeling (CR), eccentric hypertrophy (EH) and concentric hypertrophy (CH), which was defined based on the combination of LVH and high RWT.ResultsThe magnitude of association of central obesity defined by WHtR with LVH [odds ratio (OR) =10.09, 95% confidence interval (CI) =6.66-15.29] was similar with general obesity defined by BMI (OR=10.49, 95% CI=6.97-15.80), and both were higher than central obesity defined by WC (OR=6.87, 95% CI=4.57-10.33). Compared with BMI, WHtR had better or similar predictive utility for identifying LVH, EH, and CH [the area under the curve (AUC): 0.84 vs. 0.79; 0.84 vs. 0.77; 0.87 vs. 0.88, respectively]; WC had worse or similar discriminatory utility with AUCs of 0.73, 0.70, 0.83, respectively.ConclusionWHtR performed similarly or better than BMI or WC for identifying LVH and LVG remodeling among Chinese children. WHtR provides a simple and convenient measure of central obesity that might improve the discrimination of children with cardiac structural damage.

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“…Obesity is related to cardiovascular (CV) risk (including hyperglycemia, elevated blood pressure, dyslipidemia, metabolic syndrome, and insulin resistance) (5) and short-term target organ damage (6, 7) in childhood. For example, obesity increases the risk of left ventricular hypertrophy (LVH) and left ventricular geometric (LVG) remodeling (8)(9)(10)(11) (markers of cardiac structural damage), which are independent predictors of cardiovascular disease (CVD) (12,13).…”

Section: Introductionmentioning

confidence: 99%

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Anthropometric and Biochemical Markers as Possible Indicators of Left Ventricular Abnormal Geometric Pattern and Function Impairment in Obese Normotensive Children

Cited by 5 publications

References 67 publications

Metabolic syndrome as risk factor for left ventricular hypertrophy in children with chronic kidney disease

Metabolic syndrome as risk factor for left ventricular hypertrophy in children with chronic kidney disease

Utility of Three Adiposity Indices for Identifying Left Ventricular Hypertrophy and Geometric Remodeling in Chinese Children

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