Abdominal obesity, measured by waist circumference, was the only significant independent correlate of left atrial area in children after adjusting for blood pressure, left ventricular mass, and HOMA-IR (P<0.001).
Cross-Sectional (n=84)
Is left atrial enlargement associated with obesity and insulin resistance in children?
Left atrial enlargement is present in childhood and independently correlates with abdominal obesity (waist circumference), suggesting early cardiovascular risk in children with central obesity.
p-value: p=<0.001
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.
Hirschler et al. (Wed,) conducted a cross-sectional in Obesity and insulin resistance (n=84). Abdominal obesity and insulin resistance vs. Non-obese children was evaluated on Left atrial area (p=<0.001). Abdominal obesity, measured by waist circumference, was the only significant independent correlate of left atrial area in children after adjusting for blood pressure, left ventricular mass, and HOMA-IR (P<0.001).