December 1, 1995Circulation279 citations
Effect of Lean Body Mass, Fat Mass, Blood Pressure, and Sexual Maturation on Left Ventricular Mass in Children and Adolescents
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Key Result
Lean body mass was the strongest independent determinant of left ventricular mass, explaining 75% of its variance, whereas fat mass and systolic blood pressure explained only 1.5% and 0.5%.
Key Points
- Investigate how lean body mass, fat mass, and blood pressure influence left ventricular mass in children and adolescents.
- Cross-sectional evaluation of 201 subjects aged 6 to 17 years
- Echocardiography used to determine left ventricular mass
- Dual-energy x-ray absorptiometry used for body composition analysis
- Lean body mass explained 75% of the variance in left ventricular mass
- Fat mass and systolic blood pressure explained only 1.5% and 0.5% of the variance, respectively
- Lean body mass was the strongest determinant across all race-sex groups
Study Design
Type
Cross-Sectional (n=201)
Structured PICO
What are the independent determinants of left ventricular mass in normal children and adolescents?
P
Population
201 children and adolescents (105 boys, 96 girls; 103 white and 98 black) aged 6 to 17 years.
O
Outcome
Left ventricular mass determined by echocardiography and its relationship with lean body mass, fat mass, blood pressure, and sexual maturation.surrogate
Lean body mass is the primary determinant of left ventricular mass in children and adolescents, with fat mass and systolic blood pressure playing only minor roles.
Main Result
Effect estimate: 75% variance explained by lean body mass
Abstract
BACKGROUND: Left ventricular hypertrophy has been established as an independent risk factor for the development of cardiovascular morbidity and mortality. It is clear that left ventricular mass increases during childhood and adolescence with body growth. The extent to which other factors, such as obesity, stage of sexual maturation, and level of blood pressure, determine left ventricular mass has been controversial. METHODS AND RESULTS: The study was a cross-sectional evaluation of the relationship of left ventricular mass determined by echocardiography with lean body mass and fat mass determined by dual-energy x-ray absorptiometry, which is the most valid and reliable method for determination of body composition in children and adolescents. The relationship of left ventricular mass with the stage of sexual maturation and with systolic and diastolic blood pressure was also evaluated. Two hundred one subjects (105 boys, 96 girls; 103 white and 98 black) 6 to 17 years old were studied. Age (r = .72), height (r = .81), weight (r = .84), body surface area (r = .87), sexual maturation (r = .75), lean body mass (r = .86), fat mass (r = .54), systolic BP (r = .58), and diastolic BP (r = .48) were all univariate correlates of left ventricular mass. In a multiple regression analysis, only lean body mass, fat mass, and systolic blood pressure were statistically significant independent correlates of left ventricular mass. Lean body mass alone explained 75% of the variance of left ventricular mass, whereas fat mass and systolic blood pressure explained only 1.5% and 0.5% of the variance, respectively. Lean body mass was the strongest determinant of left ventricular mass in all four race-sex groups. CONCLUSIONS: This study provides an opportunity to separate the effects on left ventricular mass of lean body mass resulting from linear growth from those of fat mass resulting from obesity. Lean body mass, fat mass, and systolic blood pressure all have a statistically significant independent association with left ventricular mass, suggesting that all three play an important biological role in determining left ventricular mass. However, fat mass and systolic blood pressure have only a small impact on left ventricular mass. This indicates that fat mass and blood pressure would be expected to be of only minor clinical importance in determining left ventricular mass in normal children and adolescents.
Cite This Study
Daniels et al. (1995) conducted a cross-sectional in Normal children and adolescents (n=201). Lean body mass, fat mass, and systolic blood pressure was evaluated on Left ventricular mass determined by echocardiography (75% variance explained by lean body mass). Lean body mass was the strongest independent determinant of left ventricular mass, explaining 75% of its variance, whereas fat mass and systolic blood pressure explained only 1.5% and 0.5%.