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

Abstract

Summary Left ventricular diastolic function (LVDF) is an important marker of early cardiovascular remodelling, which has not been well summarized in young people with overweight/obesity. Weighted, random‐effects regression was used to determine the strength of associations of both body mass index (BMI) and homeostatic model assessment of insulin resistance (HOMA‐IR) with LVDF measures, adjusting for age and sex. Six databases were searched after PROSPERO registration (CRD42020177470) from inception to July 2020 for studies that compared LVDF between overweight/obesity and control groups aged ≤24 years, yielding 70 studies (9983 individuals). Quality and risk of bias were assessed using NHLBI tools, with scores of good, fair, and poor for 6, 48, and 16 studies, respectively. Increased BMI was associated with worse LVDF in all measures except early mitral inflow deceleration time, with septal early diastolic tissue peak velocity to late diastolic tissue peak velocity ratio having the strongest association (n = 13 studies, 1824 individuals; r = −0.69; P < 0.001). Elevated HOMA‐IR was also associated with worse LVDF. Although we could not determine the causality of reduced LVDF in young people, our findings should aid the development of paediatric guidelines for the assessment of LVDF and support further work to address the longitudinal consequences of childhood obesity and IR on LVDF.

Association between glycosylated hemoglobin levels, diabetes duration, and left ventricular diastolic dysfunction in patients with type 2 diabetes and preserved ejection fraction: a cross-sectional study

“…Larger patient cohorts are necessary for further investigation to validate these differences. Consistent with our findings, obesity and smoking in adolescents have been linked to increased left ventricular volume and reduced myocardial diastolic function ( 20 , 31 , 32 ). Our study also depicted the impact of BMI on cardiac function, but no significant correlation was seen between smoking and cardiac function parameters, potentially due to the limited number of smokers included in our study.…”

Echocardiographic Assessment of Patients with Glycogen Storage Disease in a Single Center

“…This may be because there were only two pediatric patients with an LV mass z-score of > 2; thus, it was not a comparative evaluation of patients with LV hypertrophy and those without. A recent meta-analysis by Burden et al showed reduced diastolic dysfunction with an increased E/e' ratio and decreased E/A ratio in children with obesity [30]. This is similar to the results of our study showing that a higher BMI z-score was associated with a lower E/A z-score, and a higher TG was associated with a higher E/e' z-score.…”

The impact of Allied Health Professionals on the primary and secondary prevention of obesity in young children: A scoping review

“…Input from AHPs into the design and/or implementation of primary and secondary prevention strategies may contribute to reduced incidence of overweight/obesity in young children. This is of vital importance to public health given the potential development of sub‐clinical disease in children living with overweight and/or obesity 7,8 . In addition, obesity may also track into adulthood and lead to the development of clinical disease such as type 2 diabetes 10–12 …”

“…This is of vital importance to public health given the potential development of sub-clinical disease in children living with overweight and/or obesity. 7,8 In addition, obesity may also track into adulthood and lead to the development of clinical disease such as type 2 diabetes. 10-12…”

“…6 There may also be subclinical alterations in relation to cardiovascular (e.g. cardiac morphology and function) 7,8 and metabolic outcomes (i.e. physiological indicators of metabolic syndrome) 9 in children and adolescents living with obesity.…”