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Weight status change during four years and left ventricular hypertrophy in Chinese children
Qin Liu1, Cheng Li2, Lili Yang2
1Department of Ultrasound, Children's Hospital of the Capital Institute of Pediatrics, Beijing, China.
Insights
Reversing childhood overweight to normal weight may reduce left ventricular hypertrophy (LVH) risk. Persistent overweight in children is linked to increased LVH, but weight loss might offer protective cardiovascular benefits.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Health
- Obesity Research
Background:
- Overweight and obesity are established risk factors for left ventricular hypertrophy (LVH) in children.
- The impact of weight status reversal from overweight to normal weight on LVH in pediatric populations remains unclear.
Purpose of the Study:
- To investigate the association between changes in weight status over four years and the incidence of LVH in Chinese children.
- To determine if weight loss in children can mitigate the risk of developing LVH.
Main Methods:
- Prospective cohort study involving 1,178 Chinese children without baseline LVH.
- Children were categorized into four groups based on weight status (normal weight, overweight/obesity) at baseline (2017) and follow-up (2021): persistent normal weight, incident overweight, reversal to normal weight, and persistent overweight.
- Left ventricular mass index (LVMI) and the risk of LVH were assessed after adjusting for confounding factors.
Main Results:
- Children with incident overweight and persistent overweight exhibited significantly higher LVMI compared to those with persistent normal weight.
- Persistent overweight (OR=5.14) and incident overweight (OR=3.34) were associated with an increased risk of LVH.
- Children who reversed from overweight to normal weight showed a non-significant trend towards lower LVMI and a reduced risk of LVH (OR=0.76).
Conclusions:
- Childhood overweight is positively associated with increased left ventricular mass.
- Weight loss in children may attenuate the risk and progression of left ventricular hypertrophy.
Objective:
It is well-established that overweight/obesity is a major risk factor for left ventricular hypertrophy (LVH) in childhood. However, it is still unclear if reversing from overweight/obesity to normal weight is associated with decreased LVH in children. This study aimed to examine the association between weight status change during four years and LVH among Chinese children based on a prospective cohort study.
Methods:
Data were obtained from the Huantai Childhood Cardiovascular Health Cohort Study in China. A total of 1,178 children without LVH at baseline (mean age: 8.3 years) were included in this study. According to weight status [normal weight or overweight (including obesity)] at baseline (2017) and follow-up (2021), children were divided, based on sex- and age-adjusted body mass index (BMI), into four groups: persistent normal weight (normal weight at both baseline and follow-up), incident overweight (normal weight at baseline but overweight at follow-up), reversal to normal weight (overweight at baseline but normal weight at follow-up), persistent overweight (overweight at both baseline and follow-up).
Results:
After adjustment for potential confounding factors, children with incident overweight (n = 114, 30.63 ± 4.74 g/m2.7) and those with persistent overweight (n = 363, 31.56 ± 6.24 g/m2.7) had higher left ventricular mass index (LVMI) at the end of the follow-up period than those with persistent normal weight (n = 632, 28.46 ± 7.64 g/m2.7), while those who reversed from overweight to normal weight had a non-significantly lower LVMI (n = 69, 28.51 ± 4.28 g/m2.7). Compared to children with persistent normal weight, those with persistent overweight [odds ratio (OR) = 5.14, 95% confidence interval (CI) = 3.33-7.95] and those with incident overweight (OR = 3.34, 95% CI = 1.77-6.30) had an increased risk of LVH. The risk of LVH tended to decrease, although not significantly, in those who reversed from overweight to normal weight (OR = 0.76, 95% CI = 0.22-2.55).
Conclusion:
Our findings demonstrate a positive association between overweight and left ventricular mass in children and suggest that LVH in childhood could be attenuated by weight loss.
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