评估胰岛素抵抗对肥胖儿童心电图参数的影响
1Department of Pediatrics, SBU Tepecik Training and Research Hospital, Izmir, Turkey. drkaanyildiz@gmail.com.
European review for medical and pharmacological sciences
|October 2, 2023
概括
患有胰岛素耐药性的肥胖儿童表现出更高的Tp-e间隔和Tp-e/QT比率,这表明心室心律失常的风险增加. 建议定期对这些患者进行心电图和霍尔特监测,以进行早期检测.
科学领域:
- 儿科内分泌学 儿科内分泌学
- 心脏病学 心脏病学
- 代谢障碍 代谢障碍 代谢障碍
背景情况:
- 肥胖与心律失常和突然死亡风险增加有关,可能是由于胰岛素抵抗和自主功能障碍.
- 腹腔再极化异常与肥胖个体的心脏事件有关.
- 肥胖儿童是一个脆弱的人群,需要对心脏风险进行调查.
研究的目的:
- 在肥胖儿童中评估腹腔再极化参数.
- 评估肥胖,胰岛素抵抗和心室失常风险之间的关联.
- 确定特定的ECG标志物,表明肥胖儿童心脏风险增加.
主要方法:
- 50名肥胖儿童 (2-18岁) 的前性评估,使用12心电图.
- 测量心率,P波分散 (Pwdisp),QT分散 (QTd),QTc间隔分散 (QTcd) 和T峰-趋势间隔 (Tp-e).
- 计算Tp-e/QT和Tp-e/QTc比率,并根据胰岛素抵抗状况进行分层分析.
主要成果:
- 与没有胰岛素抵抗的儿童相比,患有胰岛素抵抗的肥胖儿童的Tp-e间隔和Tp-e/QT比率显著更高.
- 在胰岛素抵抗患者体质指数 (BMI) SDS和QTcmax/QTcmin值之间观察到负相关性.
- 这些发现表明肥胖儿童,特别是胰岛素耐药儿童的腹腔再极化发生变化.
结论:
- 在胰岛素耐药肥胖儿童中,Tp-e间隔和Tp-e/QT比率升高是心室心律失常风险的敏感指标.
- 对脱极化和再极化参数进行全面的心电图评估对于肥胖儿童至关重要.
- 建议每年进行24小时的霍尔特监测,以早期检测肥胖儿童的心律不整,无论胰岛素抵抗状况如何.
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