Endothelial dysfunction and left ventricular hypertrophy in obese children

2000 Fiscal Year Final Research Report Summary

• Project/Area Number: 11670796
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Single-year Grants
• Section: 一般
• Research Field: Pediatrics
• Research Institution: Tokyo Women's Medical University
• Principal Investigator: KONDO Chisato Tokyo Women's Medical University, PEOIATRIC CARDIOLOGS, Assisstant Professor, 医学部, 助手 (90192070)
• Project Period (FY): 1999 – 2000
• Keywords: Obesity / left ventricular hypertrophy / endothelial dysfunction / children / 血管内皮障害 / 内臓脂肪 / PAI-1

Research Abstract

[Purpose and Methods] To clarify the effects of obesity on left ventricular hypertrophy and vascular endothelial function in children, we evaluated body mass index (BMI), abdominal fat thickness, serum lipid profile, left ventricular mass and percent flow mediated dilation (%FMD) of brachial artery in 43 children and adolescents (age 10.7 years, height 148cm, weight 60.7 kg, (mean)). We also measured blood insulin concentration, fast blood glucose, HOMA insulin resistance index, and plasminogen activator inhibitor-1(PAI-1) concentration. [Results] Four of the 43 obese patients were diagnosed as left ventricular hypertrophy defined as >45 g^*m ^<-2.7> in left ventricular mass index (LVMI). Multiple stepwise regression analysis demonstrated only BMI is independently related to LVMI.BMI accounted for 46% of changes in LVMI.PAI-1 was independently related to insulin concentration, and abdominal fat thickness was related to PAI-1. Left ventricular hypertrophy was mainly concentric type rather than eccentric type, and LV wall thickness standardised by height (LVWT/height) correlated with BMI significantly(r=0.35, p=0.02). %FMDs in obese subjects were significantly less than those in age matched normal controls (13.1±5.3 vs. 6.6±5.2 %, p<0.001). %FMD in obese was inversely correlated with LVWT/height (r=-0.43, p=0.005) and LVMI (r=-0.35, p=0.027), respectively. In conclusion, these results suggested that left ventricular hypertrophy in obese children was mainly concentric and independently related to BMI.Pathogenesis of the LV hypertrophy may be related to endothelial dysfunction in obesity.