Adiposity, cardiac size and precursors of coronary atherosclerosis in 5 to 15-year-old children: a retrospective study of 210 violent deaths
Abstract
Objective To determine the relationship between cardiac size and various measures of adiposity in children and the occurrence of coronary fatty streaks in relation to childhood obesity.Design A retrospective study based on 210 medico-legal autopsies of 5-15 y old children who had suffered violent death in the Province of Oulu, Finland, in 1970-1995.Methods Autopsy reports with attached clinical data and police records were recovered from the archives of the Department of Forensic Medicine, University of Oulu, Finland. All 5-15 y old individuals who had died of external trauma and were not documented as having had any chronic illnesses were chosen for investigation. The following data were extracted from the papers: age, sex, height, body weight, heart weight, liver weight, total weight of the kidneys, thickness of the abdominal subcutaneous fat and description of the coronary arteries. Heart weight was indexed to height2.7, and liver weight and kidney weight were indexed to body weight, body surface area and height. The ponderal index (body weight/height3) was calculated, and relative body weight was determined as the percentage deviation of the weight from the mean weight for height according to a growth chart developed for Finnish children.Results The average absolute heart weight and heart weight/height2.7 were significantly higher in the boys than in the girls over 12 y of age. Abdominal subcutaneous fat was thicker in the girls, but there were no significant differences in the other indicators of obesity. After adjusting for age, there were significant positive correlations between the ponderal index and heart weight/height2.7 in both the boys (P = 0.000) and the girls (P = 0.038), between relative body weight and heart weight/height2.7 in the boys (P = 0.000) and the girls (P = 0.027), and between abdominal subcutaneous fat thickness and heart weight/height2.7 in the boys (P = 0.045) but not in the girls (P = 0.234). Multiple linear regression analysis showed the ponderal index to be a significant predictor of heart weight/height2.7. Coronary intimal fatty streaks were documented in six individuals (2.9%), five of them having a ponderal index above the average and all of them having a relative weight above the average. Kidney weights were higher in the boys and were positively correlated with the measures of obesity and with heart weight/height2.7.Conclusions The results point to an important role of excess body weight and adiposity in the development of early myocardial and coronary changes in childhood: coronary fatty streaks were not found at all in the leanest individuals in this relatively large group and the cardiac size adjusted for body size indicated hypertrophy with increasing adiposity. Prospective autopsy studies are needed in order to determine whether adiposity and the regional distribution of fat, especially intra-abdominal fat accumulation, are associated with the earliest signs of myocardial hypertrophy and the initial phase of lesion development in the arterial intima of children.
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Central obesity is a risk marker, and probably a risk factor, for the development and progression of coronary artery disease.
“Indeed, central obesity is undeniably a risk marker, and probably a risk factor for the development and progression of coronary artery disease (43, 105, 185–188, 229, 241, 328).”
From Cardiac remodeling in obesity (2008) · cites this paper as [185]
Autopsy series have shown cardiac hypertrophy plus a variable extent of coronary artery disease in obese and nonobese subjects.
“However, autopsy series present the opportunity to study heart tissue from obese and nonobese subjects, and in general, these studies have shown cardiac hypertrophy plus a variable extent of coronary artery disease (9, 64, 91, 147, 185–188, 300).”
From Cardiac remodeling in obesity (2008) · cites this paper as [185]
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Артеријска хипертензија гојазне деце и адолесцената
Peco‐Antić, A. (2009)
- Authors
- Kortelainen, M.-L.
- Affiliations
- University of Oulu (FI)
- Corresponding author
- Kortelainen, M-L
- Venue
- International Journal of Obesity
- Published
- 1997-08
- Volume
- 21
- Issue
- 8
- Pages
- 691-697
- ISSN
- 0307-0565 (ISSN-L)
- 1476-5497
- OpenAlex
- W2043770949
- Cited by
- 32
- References
- 0
- Citations by year
- 2023: 1 · 2015: 1 · 2013: 3
- FWCI
- 0.46
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- International Journal of Obesity (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Disease and Adiposity
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Keywords
- childhood obesity, adiposity, heart size, heart weight, coronary artery disease, ponderal index, relative body weight, subcutaneous abdominal fat, violent death, forensic autopsy, sex differences, liver weight, kidney weight, Finnish children, cardiovascular risk in children, growth charts
- MeSH terms
- Adipose Tissue, Adolescent, Arteriosclerosis, Autopsy, Body Height, Body Weight, Child, Child, Preschool, Coronary Vessels, Female, Heart, Cardiomegaly, Humans, Kidney, Liver, Male, Obesity, Organ Size, Retrospective Studies, Sex Factors, Linear Models
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