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.

Obesity (OB) in adults is associated with insulin resistance, hypertension, and left atrial (LA) enlargement. This study aimed to determine the association between LA size and (1) different components of the metabolic syndrome (body mass index [BMI], waist circumference [WC], insulin levels, lipid levels, and blood pressure), and (2) left ventricular (LV) diameters and diastolic function. Data were collected cross-sectionally from 142 healthy adolescent boys age 16.8 ± 2.0 years in 2009. Measurements of BMI, WC, blood pressure, lipid profile, and insulin were performed. Mode M, two-dimensional Doppler echocardiography was performed. Measurements of LA area, LV end diastolic diameter (EDD), end systolic diameter (ESD), posterior wall, interventricular septum (IVS), and shortening fraction were performed. Tisular Doppler of the diastolic mitral annular E wave (DTE) and A wave (DTA) and the ratio of maximal early diastolic filling wave velocity to maximal early diastolic myocardial velocity (E/e') were recorded. The study group included 38 OB boys (26.8%) and 32 overweight boys (22.5%). Significant univariate association was found between LA area and BMI (r = 0.61), WC (r = 0.56), systolic blood pressure (r = 0.21), insulinemia (r = 0.28), high-density lipoprotein-cholesterol (HDL-C) (r = -0.24), triglycerides (r = 0.20), EDD (r = 0.25), LV posterior wall (r = 0.25), IVS (r = 0.25), DTE (r = 0.27), DTA (r = 0.30), and E/e' (r = -0.28). Multiple linear regression analysis showed that LA area was associated with BMI (B = 0.61; R (2) = 0.47) adjusted for confounding variables. In adolescents, BMI and WC were significantly associated with LA, suggesting that OB could be associated with LA enlargement as early as adolescence.