Predictive Markers of Early Cardiovascular Impairment and Insulin Resistance in Obese Pediatric Patients

Trandafir, Laura Mihaela; Cojocaru, Elena; Moscalu, Mihaela; Leon‐Constantin, Maria‐Magdalena; Miron, Ingrith; Maștaleru, Alexandra; Teslariu, Oana; Datcu, Madalina; Fotea, Silvia; Frăsinariu, Otilia

doi:10.3390/diagnostics11040735

Cited by 3 publications

(2 citation statements)

References 35 publications

(27 reference statements)

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“…The main study findings can be summarized as follows. First, confirming recent findings [ 8 , 9 , 11 , 22 ] markers of obesity such as body weight, BMI and waist circumference are strongly correlated LVMI in a pediatric population homogeneous in terms of biochemical profile and BP parameters. Second, the correlation was detected not only with left ventricular mass, but also with left atrial dimensions and RWT, i.e.…”

Section: Discussionsupporting

confidence: 86%

Association Between Elevated Body Mass Index and Cardiac Organ Damage in Children and Adolescents: Evidence and Mechanisms

Annaloro,

Invernizzi,

Aguilar

et al. 2024

High Blood Press Cardiovasc Prev

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Introduction Although a number of pathophysiological aspects of childhood obesity have been reported, few information are available on obesity-related cardiac organ damage. Aim The present study was aimed at assessing the impact of anthropometric, blood pressure (BP) and metabolic variable on cardiac structure and function in youth. Methods In 78 subjects aged 5–16 years attending the outpatient clinic of cardiovascular risk (Valencia, Spain) anthropometric and metabolic variables, clinic and ambulatory BP and echocardiographic parameters were assessed. Subjects were also classified according to the presence of insulin resistance. Results Subjects mean age (± SD) amounted to 12.03 ± 2.4 years and males to 53.8%. Ten subjects were normoweight, 11 overweight, 39 obese, and 18 severely obese. No significant difference in office and ambulatory BP was detected among different bodyweight groups. A significant direct correlation was observed between left ventricular mass index (LVMI) and obesity markers [body mass index (BMI): r = 0.38, waist circumference (WC): r = 0.46, P < 0.04 for both]. Left ventricular hypertrophy, relative wall thickness and left atrial diameter were significantly related to BMI and WC. In contrast, office and ambulatory BP were unrelated to other variables, and differences in LVMI among different BP phenotypes were not significant. When partitioning the population by insulin resistance, LVMI, adjusted for confounders, was significantly greater in the insulin-resistant group. Conclusions In children and adolescents characterized by different body weight patterns, weight factors “per se” and the related insulin resistance state appear to represent the main determinants of LVMI and left ventricular hypertrophy, independently on BP values and BP phenotypes. Supplementary Information The online version contains supplementary material available at 10.1007/s40292-024-00633-5.

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Section: Discussionsupporting

confidence: 86%

Association Between Elevated Body Mass Index and Cardiac Organ Damage in Children and Adolescents: Evidence and Mechanisms

Annaloro,

Invernizzi,

Aguilar

et al. 2024

High Blood Press Cardiovasc Prev

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“…In addition, the correlation between EAT thickness and insulin resistance (IR) has been widely studied both in adult and pediatric populations. IR represents a crucial marker in cardiovascular disorder development, starting in childhood [29]. In particular, EAT could cause the development or worsening of IR by increasing free fatty acids and inflammatory cytokines such as TNF, IL1, and IL6; increasing resistin release; and decreasing adiponectin levels [30].…”

Section: Children With Obesitymentioning

confidence: 99%

Assessment of Epicardial Fat in Children: Its Role as a Cardiovascular Risk Factor and How It Is Influenced by Lifestyle Habits

Calcaterra,

Cena,

Garella

et al. 2024

Nutrients

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Epicardial adipose tissue (EAT) stands out as a distinctive repository of visceral fat, positioned in close anatomical and functional proximity to the heart. EAT has emerged as a distinctive reservoir of visceral fat, intricately interlinked with cardiovascular health, particularly within the domain of cardiovascular diseases (CVDs). The aim of our overview is to highlight the role of EAT as a marker for cardiovascular risk in children. We also explore the influence of unhealthy lifestyle habits as predisposing factors for the deposition of EAT. The literature data accentuate the consequential impact of lifestyle choices on EAT dynamics, with sedentary behavior and unwholesome dietary practices being contributory to a heightened cardiovascular risk. Lifestyle interventions with a multidisciplinary approach are therefore pivotal, involving a nutritionally balanced diet rich in polyunsaturated and monounsaturated fatty acids, regular engagement in aerobic exercise, and psychosocial support to effectively mitigate cardiovascular risks in children. Specific interventions, such as high-intensity intermittent training and circuit training, reveal favorable outcomes in diminishing the EAT volume and enhancing cardiometabolic health. Future clinical studies focusing on EAT in children are crucial for advancing our understanding and developing targeted strategies for cardiovascular risk management in this population.

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Body mass index in type 2 spinal muscular atrophy: a longitudinal study

et al. 2022

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The aim of this retrospective study was to review body mass index (BMI) in a large cohort of Italian pediatric type 2 spinal muscular atrophy (SMA) patients, aged between 0 and 20 years and to establish possible differences in relation to a number of variables such as ventilation, motor function, and survival motor neuron 2 gene copies. Cross-sectional data were collected from 102 patients for a total of 344 visits. Standard growth charts for height and weight were used as reference, with age adjusted BMI calculated using the Center for Disease and Prevention Children’s BMI Tool. In the 344 visits, weight ranged between 3.90 and 83 kg, and the BMI between 8.4 and 31.6 with a BMI/age z-scores < − 2SD present in 28% and BMI/age z-scores > + 2SD in 9% of the measurements. The BMI/age z-scores were relatively stable < 5 years of age with an increasing number of patients < − 2SD after the age of 5, and a wider range of BMI/age z-scores after the age of 13. A difference on the BMI/age z-scores was found among the different age subgroups (< 5, 5–12, ≥ 13 years). A multivariate analysis in 58 patients with longitudinal assessments showed that baseline BMI/age z-scores and gender were significantly contributing to the changes while other variables were not.Conclusion: Our results confirm that careful surveillance of weight and BMI/age z-scores is needed in type 2 SMA. Further studies, including assessments of chewing and swallowing and of lean/fat body mass, will help to better understand the possible mechanisms underlying weight issues. What is Known:• Feeding difficulties have been reported in a few studies and were invariably found in patients with type 1 SMA.• Type 2 SMA patients often have low BMI with a relevant number of patients requiring tube feeding. What is New:• Reduction in BMI/age z-score overtime appeared to depend on baseline BMI/age z-score and gender.• Patients with a low BMI/age z-score were at higher risk of developing further reduction.

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Predictive Markers of Early Cardiovascular Impairment and Insulin Resistance in Obese Pediatric Patients

Cited by 3 publications

References 35 publications

Association Between Elevated Body Mass Index and Cardiac Organ Damage in Children and Adolescents: Evidence and Mechanisms

Association Between Elevated Body Mass Index and Cardiac Organ Damage in Children and Adolescents: Evidence and Mechanisms

Assessment of Epicardial Fat in Children: Its Role as a Cardiovascular Risk Factor and How It Is Influenced by Lifestyle Habits

Body mass index in type 2 spinal muscular atrophy: a longitudinal study

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