Insulin resistance surrogates and left ventricular hypertrophy in normotensive obese children
Ljiljana Bjelakovic1, Vladimir Vukovic2, Sanja Stankovic3
1Department of medical science, Faculty of Sport and Physical Education, University of Nis, Nis, Serbia.
Insights
Insulin resistance, measured by the Homeostasis Model Assessment index, is linked to increased left ventricular relative wall thickness in obese children. This finding may help identify children at risk for heart remodeling.
Area of Science:
- Pediatric Cardiology
- Metabolic Syndrome Research
- Cardiovascular Health in Obesity
Background:
- The link between insulin resistance markers and cardiac structure in obese children remains under-investigated.
- Obesity in children is associated with metabolic disturbances and cardiovascular risks.
Purpose of the Study:
- To investigate the association between insulin sensitivity/resistance indices and left ventricular geometry in normotensive obese children.
- To explore the utility of Homeostasis Model Assessment index (HOMA-IR) as a predictor of cardiac changes.
Main Methods:
- Cross-sectional study of 32 normotensive obese children.
- Echocardiography assessed left ventricular mass index and relative wall thickness.
- HOMA-IR, serum uric acid, and TG/HDL-C ratio served as insulin resistance markers.
Main Results:
- A significant positive correlation was found between HOMA-IR and left ventricular relative wall thickness (r=0.47, p=0.03), persisting after BMI adjustment (r=0.48, p=0.03).
- A HOMA-IR cutoff of ≥5.51 predicted concentric remodeling with 83.33% sensitivity and 68.75% specificity.
Conclusions:
- Elevated HOMA-IR is associated with increased left ventricular relative wall thickness in obese children.
- HOMA-IR may serve as a valuable tool to identify obese children at risk for concentric left ventricular remodeling.
Background:
The relationship between different surrogates of insulin resistance and left ventricular geometry in obese children is still unclear.
Objective:
We sought to explore the relationship between commonly used measures of insulin sensitivity/resistance (homeostatic model assessment index, serum uric acid, and triglycerides to high-density lipoprotein cholesterol ratio) and left ventricular geometry in normotensive obese children.
Methods:
In this cross-sectional study, 32 normotensive obese children were examined. Transthoracic echocardiography was used to measure left ventricular mass index and relative wall thickness. Homeostasis model assessment index, serum uric acid level, and a ratio of triglycerides to high-density lipoprotein cholesterol were used as markers of the insulin resistance. Simple and partial correlation analyses (to control for the effects of body mass index) were conducted to explore relationship between studied variables and left ventricular mass index or relative wall thickness as outcome variables.
Results:
We found positive correlations between homeostasis model assessment index and relative wall thickness (r = 0.47, p = 0.03) which remained significant after controlling for the effect of body mass index, z-score (r = 0.48, p = 0.03). The cutoff level of homeostasis model assessment index with the optimum sensitivity (Sn) and specificity (Sp) derived from the receiver operating characteristic (ROC) curves for predicting concentric remodelling was ≥5.51 with Sn = 83.33 and Sp = 68.75.
Conclusion:
There is a positive relationship between homeostasis model assessment index and relative wall thickness of obese normotensive children which may help to distinguish at risk obese normotensive children for the development of concentric left ventricular remodelling.
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