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Obese children show signs of potential heart problems

Higher LDL cholesterol, insulin and left ventricular mass than non-obese children

Louise Prime

Thursday, 09 October 2014

Obese children already show significant changes to their heart structure and function compared with children of a healthy weight, research has shown. Authors of the study*, published today in JACC Cardiovascular Imaging, said their work should now be followed up to see whether or not the changes they found predict adverse long-term outcomes, and if weight loss might reverse those changes.

Researchers in Leipzig, Germany, performed standardised 2-dimensional (2D) echocardiography and 2D speckle-tracking analysis on 61 obese boys and girls aged 9-16 years, and on 40 non-obese children; all the children were white. They also assessed the children’s blood chemistry, including lipids and glucose metabolism.

They found that compared with non-obese children, obese children had significantly increased blood pressure, low-density lipoprotein (LDL) cholesterol and parameters of glucose metabolism, with almost doubled fasting insulin levels, as well as lower levels of high-density lipoprotein (HDL) cholesterol.

The obese children also had relatively enlarged left- and right-sided cardiac chambers, thicker left ventricular walls and, consequently, increased left ventricular mass. Although they had similar left ventricular ejection fraction to non-obese children, obese children had decreased tissue Doppler-derived peak systolic velocity and regional basoseptal strain. Obese children also had impaired diastolic function compared with non-obese children; and longitudinal strain and circumferential strain were each independently associated with obesity.

The researchers said: “The present study demonstrates that childhood obesity, compared with an age-matched non-obese control group, is independently associated with significant changes in myocardial geometry and function … indicating an early onset of potentially unfavourable alterations in the myocardium.”

However, they acknowledged that their study design provides no information about the potential reversibility of these cardiovascular changes if the children were to lose weight, and also that the long-term clinical significance of these changes in obese children remains unknown. They concluded: “[This] will require extensive longitudinal follow-up to ultimately determine their predictive value.”

* Norman Mangner, et al. Childhood ObesityImpact on Cardiac Geometry and Function. J Am Coll Cardiol Img. 2014;():. doi:10.1016/j.jcmg.2014.08.006

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