Relationship of Cardiac Structures and Functions with Adiponectin, C-Reactive Protein and Interleukin-6 Levels in Obese Children

Objective: Obesity in childhood is associated with increased morbidity and mortality in adulthood due to cardiovascular disease. C-Reactive protein (CRP) and interleukin-6 (IL-6) levels are elevated in obese patients, whereas the adiponectin level is negatively correlated. This study was conducted to determine the effects of obesity on cardiac structure and functions and to investigate the relationship of cardiac structures and functions with CRP, Il-6, and adiponectin levels. Patients and Methods: A total of 38 obese and 30 healthy non-obese children were included. The anthropometric profiles of all the children were recorded. CRP, IL-6, adiponectin, and fasting glucose insulin levels were measured. The Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) was calculated. The children were assessed using conventional transthoracic echocardiography and tissue Doppler imaging. Results: Serum CRP, IL-6, insulin, and HOMA-IR were higher, and adiponectin levels were lower in obese subjects. Left ventricular wall thickness and dimensions, and left atrial diameter were greater in the obese group and the myocardial performance index (MPI) was measured higher (P=0.001). These alterations of cardiac structure were found to be positively correlated with body mass index (BMI), waist circumference, insulin and HOMA-IR, and negatively correlated with adiponectin. Conclusion: These alterations in cardiac structure and functions in obese children indicate cardiovascular diseases in adulthood, and can be measured by Doppler echocardiography. In addition, BMI, waist circumference, insulin, and HOMA-IR are useful parameters for both cardiac structure and cardiac functions. Adiponectin, should also be considered as a new parameter for cardiac structure.

Keywords:

cardiac functions, obesity, childhood, HOMA-IR, adiponectin interleukin-6,

PDF

___

1. Poirier P, Giles TD, Bray GA, et al. Obesity and Cardiovascular Disease: Pathophysiology, Evaluation, and Effect of Weight Loss. Circulation. 2006;113:898-918. 2. Ogden CL, Carroll MD, Curtin LR, McDowell MA, Tabak CJ, Flegal KM. Prevalence of overweight and obesity in the United States 1999-2004. JAMA. 2006;295:1549-55. 3. Gurnani M, Birken C, Hamilton J. Childhood Obesity: Causes, Consequences, and Management. Pediatr Clin North Am. 2015;62:821-40. 4. Viner R, Nicholls D. Managing obesity in secondary care: a personal practice. Arch Dis Child. 2005;90:385-90. 5. Wang Y, Wang JQ. A comparison of international references for the assessment of child and adolescent overweight and obesity in different populations. Eur J Clin Nutr. 2002;56:973-82. 6. Keskin M, Kurtoglu S, Kendirci M, Atabek ME, Yazici C. Homeostasis model assessment is more reliable than the fasting glucose/insulin ratio and quantitative insulin sensitivity check index for assessing insulin resistance among obese children and adolescents. Pediatrics. 2005;115:500-3. 7. Macumber IR, Weiss NS, Halbach SM, Hanevold CD, Flynn JT. The Association of Pediatric Obesity With Nocturnal Non-Dipping on 24-Hour Ambulatory Blood PressureMonitoring. Am J Hypertens. 2016;29:647-52. 8. Ma L, Cai L, Deng L, et al. Waist circumference is better than other anthropometric indices for predicting cardiovascular disease risk factors in Chinese Children -a Cross-Sectional Study in Guangzhou. J Atheroscler Thromb. 2016;23:320-9. 9. Boodai SA, Cherry LM, Sattar NA, Reilly JJ. Prevalence of cardiometabolic risk factors and metabolic syndrome in obese Kuwaiti adolescents. Diabetes Metab Syndr Obes. 2014;24:505-11. 10. Okada T, Saito E, Kuromori Y, et al. Relationship between serum adiponectin level and lipid composition in each lipoprotein fraction in adolescent children. Atherosclerosis. 2006;188:179-83. 11. Weiss R, Dziura J, Burgert TS, et al. Obesity and the metabolic syndrome in children and adolescents. N Engl J Med. 2004;350:2362-74. 12. Odeleye OE, de Courten M, Pettitt DJ, Ravussin E. Fasting hyperinsulinemia is a predictor of increased body weight gain and obesity in Pima Indian children. Diabetes. 1997;46:1341-5. 13. Vikram NK, Misra A, Pandey RM, Dwivedi M, Luthra K. Adiponectin, insulin resistance, and C-reactive protein in postpubertal Asian Indian adolescents. Metabolism. 2004;53:1336-41. 14. Martin LJ, Woo JG, Daniels SR, Goodman E, Dolan LM. The relationships of adiponectin with insulin and lipids are strengthened with increasing adiposity. J Clin Endocrinol Metab. 2005;90:4255- 9. 15. Berg AH, Scherer PE. Adipose tissue, inflammation, and cardiovascular disease. Circ Res. 2005;96:939-49. 16. Gøbel RJ, Jensen SM, Frøkiaer H, Mølgaard C, Michaelsen KF. Obesity, inflammation and metabolic syndrome in Danish adolescents. Acta Paediatr. 2012;101:192-200. 17. Hiura M, Kikuchi T, Nagasaki K, Uchiyama M. Elevation of serum C-reactive protein levels is associated with obesity in boys. Hypertens Res. 2003;26:541-6. 18. Iacobellis G, Ribaudo MC, Leto G, et al. Influence of excess fat on cardiac morphology and function: study in uncomplicated obesity. Obes Res. 2002;10:767-73. 19. Levent E, Goksen D, Ozyurek AR, Darcan S, Coker M. Usefulness of the myocardial performance index (MPI) for assessing ventricular function in obese pediatric patients. Turk J Pediatr. 2005;47:34-8. 20. Malavazos AE, Corsi MM, Ermetici F, et al. Proinflammatory cytokines and cardiac abnormalities in uncomplicated obesity: relationship with abdominal fat deposition. Nutr Metab Cardiovasc Dis. 2007;17:294-302. 21. Ebinc H, Ebinc FA, Ozkurt ZN, et al. Impact of adiponectin on left ventricular mass index in non-complicated obese subjects. Endocr J. 2008;55:523-8 22. Korkmaz O, Gursu HA, Karagun BS. Comparison of echocardiographic findings with laboratory parameters in obese children. Cardiol Young. 2016;26:1060-5. 23. Kibar AE, Pac FA, Ece İ, et al. Effect of obesity on left ventricular longitudinal myocardial strain by speckle tracking echocardiography in children and adolescents. Balkan Med J. 2015;32:56-63. 24. Chinali M, de Simone G, Roman MJ, et al. Impact of obesity on cardiac geometry and function in a population of adolescents: the Strong Heart Study. J Am Coll Cardiol. 2006;47:2267-73.