Cardiovascular impact of the pediatric obesity epidemic: higher left ventricular mass is related to higher body mass index

J Pediatr. 2011 May;158(5):709-714.e1. doi: 10.1016/j.jpeds.2010.10.016. Epub 2010 Dec 13.

Abstract

Objective: To compare secular changes in body mass index (BMI) and left ventricular mass (LVM) in today's children versus children of a generation earlier.

Study design: All healthy patients aged 2 to 19 years who underwent echocardiography at a single US academic medical center in 1986 to 1989 (prior era) and 2008 (current era) were included in this retrospective cross-sectional study. BMI, BMI z score, LVM indexed to height (LVMI), LVM z score, and relative wall thickness were calculated. Cardiac geometries were assigned based on LVM z score and relative wall thickness and classified as normal, concentric hypertrophy, eccentric hypertrophy, or concentric remodeling. Stepwise regression analysis was performed to identify determinants of LVMI.

Results: There were 350 subjects in the prior era and 350 age- and sex-matched subjects in the current era. Mean BMI and LVMI were both significantly higher in the current era than in the prior era (BMI, 19.9 ± 5.6 kg/m(2) vs 18.1 ± 3.8 kg/m(2), P = .0004; LVMI, 32.7 ± 7.8 g/m(2.7) vs 31.5 ± 8.1 g/m(2.7); P = .02). Determinants of LVMI in both eras were BMI z score, younger age, male sex, and African-American race.

Conclusions: Today's children have higher BMI, LVMI, and predicted cardiovascular risk than their counterparts a generation earlier. Reversal of these trends is needed, and intervention is required.

Publication types

  • Comparative Study
  • Comment

MeSH terms

  • Adolescent
  • Body Mass Index*
  • Cardiovascular Diseases / diagnostic imaging
  • Cardiovascular Diseases / epidemiology*
  • Cardiovascular Diseases / etiology
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Echocardiography
  • Female
  • Heart Ventricles / diagnostic imaging*
  • Heart Ventricles / physiopathology
  • Humans
  • Incidence
  • Male
  • Obesity / complications
  • Obesity / epidemiology*
  • Ohio / epidemiology
  • Prevalence
  • Retrospective Studies
  • Risk Factors
  • Ventricular Function, Left / physiology
  • Young Adult