Insulin resistance, serum uric acid and metabolic syndrome are linked to cardiovascular dysfunction in pediatric obesity

Genoni, Giulia; Menegon, Veronica; Secco, Gioel Gabrio; Sonzini, Michela; Martelli, Massimiliano; Castagno, Matteo; Ricotti, Roberta; Monzani, Alice; Aronici, Michele; Grossini, Elena; Mario, Carlo Di; Bona, Gianni; Bellone, Simonetta; Prodam, Flavia

doi:10.1016/j.ijcard.2017.09.031

Cited by 36 publications

(31 citation statements)

References 35 publications

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“…As previously reported (15,42,43), we also demonstrated a significant increase in both LV dimensions and LVM-index in OW and OB children compared to controls. These parameters were significantly affected by the severity of overweight, abdominal obesity, and insulin resistance.…”

Section: Systolic Myocardial Function and Myocardial Geometrysupporting

confidence: 90%

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Precocious Preclinical Cardiovascular Sonographic Markers in Metabolically Healthy and Unhealthy Childhood Obesity

et al. 2020

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Background: Childhood obesity is related to a wide spectrum of cardiovascular and metabolic comorbidities.Objectives: (1) To identify precocious, preclinical, cardiovascular sonographic modifications, in a cohort of overweight (OW) and obese (OB) children and adolescents compared to lean controls; (2) to investigate the association between clinical and metabolic variables and cardiovascular sonographic parameters; (3) to evaluate their relation with two different phenotypes of obesity: metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUO). Materials and Methods:Fifty-nine OW and OB children and adolescents (9.8 ± 2.9 years) and 20 matched lean controls underwent anthropometric, biochemical, echocardiography assessment, and sonographic evaluation of carotid artery and ascending aorta (AA). OW and OB subjects were divided in MHO and MUO, according to the Camhi et al. definition.Results: OW and OB children showed significantly higher left ventricular (LV) dimensions and mass, carotid artery intima-media thickness (CIMT), carotid stiffness [β-index, pulse wave velocity (PWV)], significantly lower mitral peak early (E) and late (A) velocity ratio (E/A ratio), and significantly impaired global longitudinal strain (GLS) compared to controls. BMI SD and HOMA-IR were positively significantly related to LV dimensions, LA volume and epicardial adipose tissue (EAT), and negative to E/A ratio. Waist circumference (WC) was positively correlated to LV dimensions, LA volume, CIMT, PWV, AA diameter, and EAT. Furthermore, WC was a strong predictor of LV dimensions, LA volume and strain, AA stiffness and diameter; BMI SD was significantly associated with EAT, LVM index, and E/A ratio; HOMA-IR and triglycerides were significant predictors of GLS. MUO patients showed higher BMI SD (p = 0.02), WC (p = 0.001), WHtR (p = 0.001), HOMA-IR (p = 0.004), triglycerides (p = 0.01), SBP (p = 0.001), as well as LV dimensions, EAT (p = 0.03), CIMT (p = 0.01), AA diameter (p = 0.02), β-index (p = 0.03) and PWV (p = 0.002), AA stiffness (p = 0.006), and significantly impaired GLS (p = 0.042) compared to MHO.Corica et al. Cardiovascular Sonographic Markers in Childhood ObesityConclusions: Severity of overweight, abdominal obesity, insulin resistance, and MUO phenotype negatively affect cardiovascular remodeling and subclinical myocardial dysfunction in OW and OB children. MUO phenotype is likely to increase the risk of developing cardiometabolic complications since the pediatric age. Distinction between MHO and MUO phenotypes might be useful in planning a personalized follow-up approach in obese children.

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Section: Systolic Myocardial Function and Myocardial Geometrysupporting

confidence: 90%

“…These parameters were significantly affected by the severity of overweight, abdominal obesity, and insulin resistance. Precocious modifications of cardiac geometry could be determined, at least in part, by preload/afterload increase related to obesity (42).…”

Section: Systolic Myocardial Function and Myocardial Geometrymentioning

confidence: 99%

Precocious Preclinical Cardiovascular Sonographic Markers in Metabolically Healthy and Unhealthy Childhood Obesity

et al. 2020

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“…Furthermore, as an independent risk factor for cardiovascular disease, serum uric acid is associated with cIMT in asymptomatic prepubertal children with higher body mass index (BMI) or more preperitoneal fat 14 . In a recent study, it was confirmed that hyperuricemia can be an early marker of cardiovascular dysfunction and the routine determination in pediatric obesity 15 . Despite many evidences admitting that uric acid is a cardiometabolic risk factor, and obesity-related hyposomatotropism is associated with classical risk factors for cardiovascular disease, to best of our knowledge, studies focusing on the association between obesity-related hyposomatotropism and hyperuricemia are still scanty.…”

Section: Introductionmentioning

confidence: 85%

Reduced peak stimulated growth hormone is associated with hyperuricemia in obese children and adolescents

Liang

Zhang

et al. 2018

Sci Rep

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The purpose of the study is to investigate whether reduced peak GH response to arginine-levodopa test is associated with hyperuricemia in obese children and adolescents. The study population consisted of a total sample of 78 obese and 30 normal-weight children and adolescents without known hypopituitarism. All participants underwent clinical examination and GH stimulation testing. IGF-1, lipid profile and other metabolic markers were assessed. The obese subjects were then divided into two groups according to the serum levels of uric acid. Results show that obese subjects had significantly lower peak GH, lower IGF-1 and similar height SDS than those in the control group. Children with hyperuricemia had significantly lower peak stimulated GH compared with non-hyperuricemia obese subjects. Results from logistic regression model showed that peak GH were negatively associated with hyperuricemia after controlling for age, gender, tanner stage, BMI SDS, IGF-1, blood pressure, HOMA-IR, lipids status. These data indicate that lower peak GH is positively associated with hyperuricemia in obese children and adolescents without known hypothalamic/pituitary disease after controlling BMI and insulin resistance, as well as other cardiometabolic risk factors.

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“…There is a possibility that hyperuricemia and gout has been also added as another factors in the future. 7 As to the treatment of metabolic syndrome, the basic therapy would be the control of the body weight. Consequently, the weight reduction should be tried at first for the treatment of metabolic syndrome and obesity prior to starting various medicine.…”

Section: Introductionmentioning

confidence: 99%

Weight reduction program with continuous psychological support in obese patients

Bando¹,

Nakamura²,

Kawashima³

et al. 2019

AOWMC

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Background: Obese subjects have been increasing worldwide. Authors have continued clinical research about Low Carbohydrate Diet (LCD) and Calorie Restriction (CR) for long, and developed LCD medically and socially through the activity of Japan LCD Promoting Association (JLCDPA). Study protocol: Enrolled subjects enrolled were 2807 patients with obesity whom we gave advices in weight reduction program. Nutritional treatment on LCD was started by super-LCD with 12% of carbohydrate. After that, the carbohydrate limitation has been relieved according to the each situation of the subjects. Furthermore, subjects have received psychological supports with Empowerment, Motivation, and Medical Adherence (EMMA) and with the relationship among recognition of self-regulation; self-determination; conscientization and struggle were provided for 6-12 months. Results and discussion: The weight changes of 2807 cases were studied with the following results: weight reduction rate of 10%

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Insulin resistance, serum uric acid and metabolic syndrome are linked to cardiovascular dysfunction in pediatric obesity

Cited by 36 publications

References 35 publications

Precocious Preclinical Cardiovascular Sonographic Markers in Metabolically Healthy and Unhealthy Childhood Obesity

Precocious Preclinical Cardiovascular Sonographic Markers in Metabolically Healthy and Unhealthy Childhood Obesity

Reduced peak stimulated growth hormone is associated with hyperuricemia in obese children and adolescents

Weight reduction program with continuous psychological support in obese patients

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