Key result
Normalization for body surface area underestimates left ventricular mass in overweight children compared to non-overweight children (mean z-score -0.64 vs 0.00), whereas height does not.
Why the study?
It remained unclear which body size variable normalizes left ventricular mass without underestimating it in overweight children.
Does normalization for body surface area or computed lean body mass underestimate left ventricular mass in overweight children compared to normalization for height?
Cross-Sectional (n=464)
Does normalization for body surface area or computed lean body mass underestimate left ventricular mass in overweight children compared to normalization for height?
Normalization of left ventricular mass for body surface area or computed lean body mass underestimates left ventricular mass in overweight children, suggesting height is a more appropriate normalizing variable.
Answers are grounded in this paper and cite their sources.
May warrant caution with BSA-based LVM norms in overweight youth; leaves open optimal indexing for pediatric studies.
BACKGROUND: Left ventricular mass normalization for body size is recommended, but a question remains: what is the best body size variable for this normalization-body surface area, height or lean body mass computed based on a predictive equation? Since body surface area and computed lean body mass are derivatives of body mass, normalizing for them may result in underestimation of left ventricular mass in overweight children. The aim of this study is to indicate which of the body size variables normalize left ventricular mass without underestimating it in overweight children. METHODS: Left ventricular mass assessed by echocardiography, height and body mass were collected for 464 healthy boys, 5-18 years old. Lean body mass and body surface area were calculated. Left ventricular mass z-scores computed based on reference data, developed for height, body surface area and lean body mass, were compared between overweight and non-overweight children. The next step was a comparison of paired samples of expected left ventricular mass, estimated for each normalizing variable based on two allometric equations-the first developed for overweight children, the second for children of normal body mass. RESULTS: The mean of left ventricular mass z-scores is higher in overweight children compared to non-overweight children for normative data based on height (0.36 vs. 0.00) and lower for normative data based on body surface area (-0.64 vs. 0.00). Left ventricular mass estimated normalizing for height, based on the equation for overweight children, is higher in overweight children (128.12 vs. 118.40); however, masses estimated normalizing for body surface area and lean body mass, based on equations for overweight children, are lower in overweight children (109.71 vs. 122.08 and 118.46 vs. 120.56, respectively). CONCLUSION: Normalization for body surface area and for computed lean body mass, but not for height, underestimates left ventricular mass in overweight children.
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Krysztofiak et al. (2019) conducted a cross-sectional in Overweight (n=464). Overweight status vs. Non-overweight status was evaluated on Mean left ventricular mass z-score based on body surface area. Normalization for body surface area underestimates left ventricular mass in overweight children compared to non-overweight children (mean z-score -0.64 vs 0.00), whereas height does not.
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