Influence of obesity and insulin resistance on left atrial size in children
Open accessAbstract
BACKGROUND: Left atrial (LA) enlargement has been linked to obesity and insulin resistance in adults. OBJECTIVE: The purpose of this study was to determine the association in children between LA area and: (i) different components of the metabolic syndrome including obesity (OB), measures of body mass index (BMI) and waist circumference (WC), homeostasis model assessment-insulin resistance (HOMA-IR, proinsulin), and blood pressure (BP); and (ii) left ventricular mass (LVM) and diastolic function, measured using echo Doppler. METHODS AND RESULTS: Eighty-four (44 females) subjects, [40 OB (BMI>95%), 28 overweight (BMI>85%)], 16 non-OB (BMI<85%)] aged 9+/-2.24 yrs were matched for sex and age. BMI, WC, BP, Tanner stage, and Mode M, 2-dimensional and Doppler transmitral echocardiography were assessed. A standard oral glucose tolerance test (OGTT) was done, measuring glucose, insulin, and proinsulin concentrations. Hypertension was only present in OB subjects (25%). Significant univariate association (p<0.001) was found between LA area and height (r=0.52), age (r=0.45), Tanner stage (r=0.45), BMI (r=0.66), WC (r=0.70), systolic BP (r=0.52), diastolic BP (r=0.53), proinsulin (r=0.36), and HOMA-IR (r=0.36). In the multivariate regression analysis, independent variables were entered in a stepwise fashion: initially, gender (p=0.006) and Tanner stage (p=0.011) were still significant independent correlates of LA area after adjusting for age, gender, and Tanner stage. Subsequently, incorporation of WC showed that WC (p=0.018) was a significant independent correlate of LA area. A larger model constructed to test the significance of adjustment factors, including WC, BP, LVM, and HOMA-IR showed that WC (p<0.001) was the only significant independent variable. CONCLUSION: LA enlargement is present in childhood and is related to abdominal OB and insulin resistance, suggesting that children with central OB are at increased risk for cardiovascular disease.
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Many studies have shown increased LA dimensions in obese subjects compared with normal-weight control subjects.
“Many studies have shown increased LA dimensions in obese subjects compared with normal-weight control subjects (16, 17, 22, 140, 274, 371, 375).”
From Cardiac remodeling in obesity (2008) · cites this paper as [140]
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- Authors
- Hirschler, V., Acebo, H. L. P., Fernandez, G. B., de Lujan Calcagno, M., Gonzalez, C., & Jadzinsky, M.
- Affiliations
- El Hospital General de Agudos Carlos G. Durand (AR)
- Corresponding author
- Hirschler, Valeria
- ORCID
- Hirschler, Valeria
- Venue
- Pediatric Diabetes
- Publisher
- Hindawi Limited
- Published
- 2006-02
- Volume
- 7
- Issue
- 1
- Pages
- 39-44
- ISSN
- 1399-543X (ISSN-L)
- 1399-5448
- OpenAlex
- W2067044819
- Cited by
- 41
- References
- 34
- Citations by year
- 2026: 1 · 2025: 1 · 2023: 1 · 2021: 2 · 2020: 2 · 2019: 1 · 2018: 2 · 2017: 4 · 2016: 1 · 2015: 5 · 2014: 2 · 2013: 5
- FWCI
- 1.42
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Pediatric Diabetes (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Keywords
- left atrial enlargement, childhood obesity, insulin resistance, metabolic syndrome, waist circumference, body mass index, proinsulin, HOMA-IR, left ventricular mass, diastolic function, blood pressure, cardiovascular risk, abdominal obesity
- MeSH terms
- Blood Pressure, Child, Diabetes Mellitus, Type 1, Female, Heart Atria, Heart Ventricles, Humans, Insulin Resistance, Male, Obesity, Proinsulin, Puberty, Regression Analysis, Echocardiography, Doppler, Body Mass Index, Multivariate Analysis
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