Early cardiac abnormalities and serum N-terminal pro B-type natriuretic peptide levels in obese children

Abstract

Objective: The aim of this study was to evaluate early cardiac abnormalities in obese children by the conventional echocardiography and to verify whether N-terminal pro B-type natriuretic peptide (NT-proBNP) differ between obese and healthy children. Methods:We started this study with 68 obese children and 35 healthy controls matched for age and sex. Body mass index (BMI) was calculated. Children with a BMI ≥ 95th percentile were considered obese. Thirty children in the obese group were also diagnosed with metabolic syndrome, according to the International Diabetes Federation criteria. Standard echocardiographic study was performed on each patient and control subject. Diastolic fi lling parameters were evaluated using pulsed-wave tissue Doppler method. Blood samples were taken at 8 a.m. to study blood biochemistry tests, including insulin, lipids, glucose, and NT-proBNP. Serum NT-proBNP levels were measured by a solid-phase, enzymelabeled chemiluminescent immunometric assay. Homeostasis model assessment of insulin resistance (HOMA-IR) was calculated. Children with HOMA-IR > 3.16 were considered insulin-resistant. Results: There were diastolic fi lling abnormalities in obese children, as shown by a decreased mitral valve early fi lling (E) wave/late fi lling (A) ratio and a prolongation in E-wave deceleration time. The levels of NT-proBNP were not statistically different among the groups. The levels of NT-proBNP were not different between obese children with and without metabolic syndrome, those with and without hypertension, and those with and without insulin resistance, respectively. Conclusion: Although there were diastolic fi lling abnormalities in obese children, their NT-proBNP levels were not different from healthy controls. It seems that there is no diagnostic value in NT-proBNP levels between obese children and healthy controls

Age-Dependent Reference Values for hs-Troponin T and NT-proBNP and Determining Factors in a Cohort of Healthy Children (The LIFE Child Study)

“…Siervo et al in their study of 151 children ( n = 38 with BMI z -score ≥ 1.64), however, found no association between BMI z -score and hsTnT or NT-proBNP levels [ 10 ]. A finding replicated by Battal et al, who evaluated 68 obese and 38 lean matched-controls and found no significant difference in NT-proBNP levels, nor any difference between obese children with or without metabolic syndrome, hypertension or insulin resistance, and NT-proBNP levels [ 11 ].…”

“…Previous studies investigating NT-proBNP and hsTnT in children have limitations, conducted in small study populations, not encompassing all pediatric age groups, or confounded by being collected during presentation for inter-concurrent illness or surgery [ 3 – 6 ]. In adults, population-based studies showed consistently negative associations between NT-proBNP and metabolic markers, such as BMI and lipid levels [ 7 – 9 ], whereas the limited data available from pediatric cohorts have not demonstrated this correlation [ 10 , 11 ]. These divergent findings could be due to different metabolic mechanisms in childhood or secondary to a sampling error from small study participant numbers.…”

The effect of overweight/obesity on diastolic function in children and adolescents: A meta‐analysis

“…Forty‐three studies eligible for systematic review reported matching LVDF measures to those included in the meta‐analysis (Figure 4). 19–21,26,28,29,33,35,37,39,40,44,46,48–50,52–54,57–59,61–81 A full list of these results is given in Table S5.…”

“…Forty‐three studies eligible for systematic review reported matching LVDF measures to those included in the meta‐analysis (Figure 4 ). 19 , 20 , 21 , 26 , 28 , 29 , 33 , 35 , 37 , 39 , 40 , 44 , 46 , 48 , 49 , 50 , 52 , 53 , 54 , 57 , 58 , 59 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 A full list of these results is given in Table S5 .…”